Ota Takahiro, Yoshida Kosuke, Suzuki Yasuhiro, Kuroda Kenji, Kimura Takashi
Department of Neurology, National Hospital Organization Asahikawa Medical Center.
Rinsho Shinkeigaku. 2021 May 19;61(5):329-331. doi: 10.5692/clinicalneurol.cn-001572. Epub 2021 Apr 17.
There have been a few reports on Dipeptidyl peptidase (DPP)-4 inhibitor-induced dropped head syndrome. However, there has been no known report on temporal changes in MRI findings. The patient described here was a 63-year-old man who was prescribed oral sitagliptin (50 mg/day) in February 2019. He experienced a dropped head from mid-January 2020, and in early April that year, he was admitted to our hospital for further evaluation. Weakness of the cervical extensor muscles (MMT 3) was noted, and MRI findings showed that the posterior cervical muscle group was hyperintense on short inversion time inversion recovery (STIR). We suspected sitagliptin to be the cause of his dropped head and discontinued it. On the 10th day of admission, his posture improved to the median position. One month after discontinuation of sitagliptin, MRI findings showed an improvement in the STIR hyperintensity of the posterior cervical muscle. In conclusion, if the initiation of a DPP-4 inhibitor results in dropped head syndrome, discontinuation of the drug should be considered.
关于二肽基肽酶（DPP）-4抑制剂诱发的垂头综合征已有一些报道。然而，关于磁共振成像（MRI）结果的时间变化尚无已知报道。本文所述患者为一名63岁男性，2019年2月开始口服西格列汀（50毫克/天）。他自2020年1月中旬开始出现垂头症状，同年4月初因进一步评估入住我院。检查发现颈伸肌肌力减弱（MMT 3级），MRI结果显示颈后肌群在短反转时间反转恢复序列（STIR）上呈高信号。我们怀疑西格列汀是导致他垂头的原因并停用了该药物。入院第10天，他的姿势改善至中位。停用西格列汀1个月后，MRI结果显示颈后肌STIR高信号有所改善。总之，如果DPP-4抑制剂的使用引发垂头综合征，应考虑停药。
