Salehi Nooshin, Choi Eric D, Garrison Roger C
Department of Medicine, Riverside University Health System, Moreno Valley, CA, USA.
School of Medicine, Loma Linda University, Loma Linda, CA, USA.
Am J Case Rep. 2017 Jan 16;18:52-59. doi: 10.12659/ajcr.901940.
BACKGROUND Miller Fisher Syndrome is characterized by the clinical triad of ophthalmoplegia, ataxia, and areflexia, and is considered to be a variant of Guillain-Barre Syndrome. Miller Fisher Syndrome is observed in approximately 1-5% of all Guillain-Barre cases in Western countries. Patients with Miller Fisher Syndrome usually have good recovery without residual deficits. Venous thromboembolism is a common complication of Guillain-Barre Syndrome and has also been reported in Miller Fisher Syndrome, but it has generally been reported in the presence of at least one prothrombotic risk factor such as immobility. A direct correlation between venous thromboembolism and Miller Fisher Syndrome or Guillain-Barre Syndrome has not been previously described. CASE REPORT We report the case of a 32-year-old Hispanic male who presented with acute, severe thromboembolic disease and concurrently demonstrated characteristic clinical features of Miller Fisher Syndrome including ophthalmoplegia, ataxia, and areflexia. Past medical and family history were negative for thromboembolic disease, and subsequent hypercoagulability workup was unremarkable. During the course of hospitalization, the patient also developed angioedema. CONCLUSIONS We describe a possible association between Miller Fisher Syndrome, thromboembolic disease, and angioedema.
米勒-费雪综合征的特征为眼肌麻痹、共济失调和腱反射消失三联征，被认为是吉兰-巴雷综合征的一种变异型。在西方国家，米勒-费雪综合征约占所有吉兰-巴雷病例的1%-5%。米勒-费雪综合征患者通常恢复良好，无残留缺陷。静脉血栓栓塞是吉兰-巴雷综合征的常见并发症，米勒-费雪综合征中也有报道，但一般是在存在至少一种血栓形成危险因素（如活动减少）的情况下。此前尚未描述静脉血栓栓塞与米勒-费雪综合征或吉兰-巴雷综合征之间的直接关联。病例报告：我们报告一例32岁西班牙裔男性病例，该患者出现急性严重血栓栓塞性疾病，同时表现出米勒-费雪综合征的典型临床特征，包括眼肌麻痹、共济失调和腱反射消失。既往病史和家族史均无血栓栓塞性疾病，随后的高凝状态检查无异常。在住院期间，该患者还出现了血管性水肿。结论：我们描述了米勒-费雪综合征、血栓栓塞性疾病和血管性水肿之间可能存在的关联。
