[吉兰-巴雷综合征合并甲型急性肝炎——1例报告及文献复习]

[Guillain-Barré syndrome associated with acute hepatitis A-A case report and literature review].

作者信息

Saito Akiko, Saito Mineki, Shimoe Yutaka, Yoshimoto Takeshi, Kawakami Mari, Okamoto Hiroaki, Yoshikawa Keisuke, Kusunoki Susumu, Kuriyama Masaru

机构信息

Department of Neurology, Brain Attack Center, Ota Memorial Hospital.

Department of Microbiology, Kawasaki Medical School.

出版信息

Rinsho Shinkeigaku. 2018 Sep 28;58(9):574-577. doi: 10.5692/clinicalneurol.cn-001165. Epub 2018 Aug 31.

DOI:10.5692/clinicalneurol.cn-001165

PMID:30175808

Abstract

A 44-year-old female developed acute hepatitis A (HA) 5 weeks after ingesting raw oysters. She developed ascending motor weakness, bilateral peripheral facial nerve palsy, and bulbar symptoms. A diagnosis of demyelinating Guillain-Barré syndrome (GBS) was made on the basis of her clinical manifestations and the results of a nerve conduction study. The patient showed improvement following combination treatment with intravascular immunoglobulin and high dose methylprednisolone. No antibodies against specific gangliosides, sulfated glucuronyl paragloboside (SGPG), or sulfatide were detected. HA virus (HAV) RNA was isolated from her serum and its full-length genome sequence was determined. It revealed a homology of 99.9% or more with HAV genotype IA (HAV-IA) of the 2014 outbreak. No mutant virus RNA was detected.

摘要

一名44岁女性在食用生牡蛎5周后患上急性甲型肝炎（HA）。她出现了上行性运动无力、双侧周围性面神经麻痹和延髓症状。根据其临床表现和神经传导研究结果，诊断为脱髓鞘性吉兰 - 巴雷综合征（GBS）。患者在接受血管内免疫球蛋白和大剂量甲基强的松龙联合治疗后病情有所改善。未检测到针对特定神经节苷脂、硫酸化葡糖醛酸副球蛋白（SGPG）或硫脂的抗体。从她的血清中分离出甲型肝炎病毒（HAV）RNA，并确定了其全长基因组序列。结果显示，与2014年疫情中的HAV基因型IA（HAV-IA）具有99.9%或更高的同源性。未检测到突变病毒RNA。