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多发运动神经病,表现为登革热感染后的并发症:一例病例报告。

Multifocal motor neuropathy presenting as a post-infectious complication of dengue: a CASE report.

机构信息

National Hospital of Sri Lanka, Colombo, Sri Lanka.

出版信息

BMC Infect Dis. 2018 Aug 22;18(1):415. doi: 10.1186/s12879-018-3334-z.

Abstract

BACKGROUND

Dengue infection is an endemic illness in the tropics and it is associated with a wide variety of post infectious complications. With the increasing prevalence of dengue infection in endemic regions, post-infectious neurological complications following dengue infection are now been reported more frequently. We report a patient who developed multifocal motor neuropathy (MMN) with conduction blocks following dengue infection during the immediate post-infectious period. MMN is a rare neurological disorder with an autoimmune etiology and to best of our knowledge this is the first reported case of MMN occurring following dengue infection as a post dengue neurological complication.

CASE PRESENTATION

A 20 year old Sri Lankan male who was treated for serologically confirmed dengue infection presented to us with 1 month history of bilateral hand weakness which has started 5 days after the dengue infection (5 days after the discharge). On examination he had asymmetrical motor weakness of the hands and to a lesser degree in feet. There was no sensory impairment. Nerve conduction studies confirmed MMN with conduction blocks. He was started on intravenous immunoglobulin therapy for which he showed a good response.

CONCLUSION

The authors report the first case of MMN complicating dengue fever in a previously healthy male from Sri Lanka. Thus it should be borne in mind that although rare, MMN can occur as a post-infectious complication of dengue fever.

摘要

背景

登革热感染是热带地区的地方病,与多种感染后并发症有关。随着流行地区登革热感染的增加,现在越来越多地报告感染后神经并发症。我们报告了一例患者,他在感染后立即出现多发性运动神经病(MMN)伴传导阻滞。MMN 是一种罕见的神经疾病,病因是自身免疫,据我们所知,这是首例报告的登革热感染后发生的 MMN 作为登革热后神经系统并发症。

病例介绍

一名 20 岁的斯里兰卡男性,因血清学确诊的登革热感染接受治疗,出现双侧手部无力 1 个月,发病于登革热感染后 5 天(感染后第 5 天)。检查时,他的手部有不对称性运动无力,程度较轻在脚上。没有感觉障碍。神经传导研究证实存在 MMN 伴传导阻滞。他开始接受静脉注射免疫球蛋白治疗,反应良好。

结论

作者报告了首例来自斯里兰卡的既往健康男性合并登革热的 MMN 病例。因此,应该记住,尽管罕见,但 MMN 可能作为登革热的感染后并发症发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0d3/6103970/bec58dd29cbf/12879_2018_3334_Fig1_HTML.jpg

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