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以视力恶化为首发症状的抗GQ1b抗体综合征:一例报告

Anti-GQ1b antibody syndrome presenting with visual deterioration as the initial symptom: A case report.

作者信息

Zhao Teng, Deng Yuyan, Ding Ying, Zhang Rensheng, Zhou Chunkui, Lin Weihong

机构信息

Department of Neurology, The First Hospital of Jilin University, Changchun, Jinlin.

Department of Intensive Care Unit, the People's Hospital of Weifang City, Weifang, Shandong.

出版信息

Medicine (Baltimore). 2020 Jan;99(4):e18805. doi: 10.1097/MD.0000000000018805.

Abstract

RATIONALE

Anti-GQ1b antibody syndrome refers to a distinct variant of Guillain- Barré syndrome. Involvement of the optic nerve in anti-GQ1b antibody syndrome is extremely rare.

PATIENT CONCERNS

Here, we report a case of anti-GQ1b antibody syndrome presenting with visual deterioration as the initial symptom. A 73-year-old man presented with a 5-day history of bilateral blurred vision and ptosis. He had a previous history of diarrhea starting 10 days before admission. Physical examination showed visual deterioration, ophthalmoplegia, and peripheral facial paralysis. Testing of both serum and cerebrospinal fluid was positive for anti-GQ1b immunoglobulin G antibodies and negative for anti-aquaporin 4antibodies.

DIAGNOSIS

Anti-GQ1b antibody syndrome.

INTERVENTIONS

The patient was treated with intravenous methylprednisolone and human immunoglobulin.

OUTCOMES

After a 20-day follow-up, the patient's condition took a favorable turn.

LESSONS

This case reminds us that anti-GQ1b antibody syndrome should be suspected in patients with visual deterioration and preceding infection.

摘要

理论依据

抗GQ1b抗体综合征是格林-巴利综合征的一种独特变体。抗GQ1b抗体综合征累及视神经极为罕见。

患者情况

在此,我们报告一例以视力恶化为首发症状的抗GQ1b抗体综合征病例。一名73岁男性,有5天双侧视力模糊和上睑下垂病史。他在入院前10天有腹泻病史。体格检查显示视力恶化、眼肌麻痹和周围性面瘫。血清和脑脊液检测抗GQ1b免疫球蛋白G抗体呈阳性,抗水通道蛋白4抗体呈阴性。

诊断

抗GQ1b抗体综合征。

干预措施

患者接受了静脉注射甲泼尼龙和人免疫球蛋白治疗。

结果

经过20天的随访,患者病情好转。

经验教训

该病例提醒我们,对于视力恶化且有前驱感染的患者,应怀疑抗GQ1b抗体综合征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c7e/7004724/f72963c9a6f5/medi-99-e18805-g001.jpg

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