Kuzume Daisuke, Sajima Kazuaki, Kon-no Yuko, Kaneko Keiko, Yamasaki Masahiro
Department of Neurology, Chikamori Hospital.
Rinsho Shinkeigaku. 2015;55(8):550-4. doi: 10.5692/clinicalneurol.cn-000683. Epub 2015 Jul 22.
Acute disseminated encephalomyelitis (ADEM) with an anti-galactocerebroside antibody is very rare. We report a case of 82-year-old man with ADEM associated with anti-galactocerebroside antibody in serum. He was admitted to our hospital after developing disturbed consciousness and respiratory failure. A cerebrospinal fluid examination disclosed an albuminocytologic dissociation and elevation of myelin basic protein. Magnetic resonance images revealed lesions in the medulla oblongata, pons, midbrain, bilateral cerebellar hemisphere and thalami. Initially, he was treated with methylprednisolone (1 g/day) for three days. His clinical symptoms improved. We found on 15(th) hospital day that an anti-galactocerebroside antibody was positive in serum without serological evidence of Mycoplasma pneumoniae infection. This case can be diagnosed as ADEM associated with an anti-galactocerebroside antibody.
伴有抗半乳糖脑苷脂抗体的急性播散性脑脊髓炎(ADEM)非常罕见。我们报告一例82岁男性,血清中存在抗半乳糖脑苷脂抗体并伴有ADEM。他在出现意识障碍和呼吸衰竭后入院。脑脊液检查显示蛋白细胞分离及髓鞘碱性蛋白升高。磁共振成像显示延髓、脑桥、中脑、双侧小脑半球及丘脑有病变。起初,他接受甲基强的松龙(1g/天)治疗三天。其临床症状有所改善。我们在住院第15天发现血清中抗半乳糖脑苷脂抗体呈阳性,且无肺炎支原体感染的血清学证据。该病例可诊断为伴有抗半乳糖脑苷脂抗体的ADEM。