Koros Christos, Evangelopoulos Maria-Eleftheria, Kilidireas Costas, Andreadou Elisabeth
1st Department of Neurology, Athens National University, "Aeginition" Hospital, 74 Vas. Sophia's Avenue, 11528 Athens, Greece.
Case Rep Neurol Med. 2013;2013:243652. doi: 10.1155/2013/243652. Epub 2013 Dec 16.
Introduction. Central nervous system involvement, either clinical or subclinical, has been reported mainly in X-linked Charcot-Marie-Tooth (CMT-X) patients. Case Presentation. We present the case of a 31-year-old man with a genetically confirmed history of CMT1A who developed CNS involvement mimicking multiple sclerosis (MS). Clinical, imaging, and laboratory findings suggested an autoimmune CNS demyelination. Discussion. Although the simultaneous existence of CMT1A and MS could be coincidental we postulate that overexpression of PMP22, the target protein in CMT1A, might influence the immunological self-tolerance to CNS proteins via molecular mimicry, leading to a CNS autoimmune demyelinating disorder.
引言。中枢神经系统受累,无论是临床的还是亚临床的,主要在X连锁型夏科-马里-图斯病(CMT-X)患者中被报道。病例报告。我们报告一例31岁男性病例,其基因确诊为CMT1A病史,出现了类似多发性硬化症(MS)的中枢神经系统受累情况。临床、影像学和实验室检查结果提示为自身免疫性中枢神经系统脱髓鞘。讨论。虽然CMT1A和MS同时存在可能是巧合,但我们推测CMT1A中的靶蛋白PMP22的过表达可能通过分子模拟影响对中枢神经系统蛋白的免疫自身耐受性,导致中枢神经系统自身免疫性脱髓鞘疾病。