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一例具有吉兰-巴雷综合征临床特征的人类佐剂病病例

[A case of human adjuvant disease with clinical features of Guillain-Barré syndrome].

作者信息

Takenouchi Akiyuki, Hosoi Yasushi, Watanabe Kazuki, Takashima Hirotsugu, Bunai Tomoyasu, Miyajima Hiroaki

机构信息

First Department of Medicine, Hamamatsu University School of Medicine.

Department of Biofunctional Imaging, Medical Photonics Research Center, Hamamatsu University School of Medicine.

出版信息

Rinsho Shinkeigaku. 2020 May 26;60(5):358-361. doi: 10.5692/clinicalneurol.cn-001364. Epub 2020 Apr 18.

Abstract

A 69-year-old female developed subacute diplopia, right peripheral facial nerve palsy, bilateral upper and lower extremities dysesthesia and weakness 50 years after silicone injection for breast augmentation. Motor conduction study revealed prolonged distal latency and reduced amplitude in the median, ulnar, and peroneal nerves. Sensory conduction velocities were reduced in the median and ulnar nerves, and sensory potential in the sural nerve could not be recorded. While intravenous immunoglobulin therapy was ineffective, explantation of silicone breast implants improved her neurological symptoms. Histopathological study of axillary lymph node revealed foreign body granulomas and macrophages phagocyting silicone. The patient was diagnosed with human adjuvant disease presenting clinical features of Guillain-Barré syndrome. Human adjuvant disease should be considered in the patients with implants like silicone and neurological symptoms.

摘要

一名69岁女性在注射硅胶隆胸50年后出现亚急性复视、右侧周围性面神经麻痹、双侧上下肢感觉异常和无力。运动传导研究显示正中神经、尺神经和腓总神经的远端潜伏期延长和波幅降低。正中神经和尺神经的感觉传导速度降低,腓肠神经的感觉电位无法记录。虽然静脉注射免疫球蛋白治疗无效,但取出硅胶乳房植入物改善了她的神经症状。腋窝淋巴结的组织病理学研究显示异物肉芽肿和吞噬硅胶的巨噬细胞。该患者被诊断为人辅助性疾病,表现为吉兰-巴雷综合征的临床特征。对于有硅胶等植入物且出现神经症状的患者,应考虑人辅助性疾病。

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