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埃塞俄比亚抗水通道蛋白 4 免疫球蛋白 G 阳性视神经脊髓炎谱系疾病:一例报告。

Aquaporin-4-IgG Positive Neuromyelitis Optica Spectrum Disorder from Ethiopia: A Case Report.

机构信息

Department of neurology, college of health sciences, Addis Ababa University, Addis Ababa Ethiopia.

出版信息

Ethiop J Health Sci. 2020 Sep;30(5):847-852. doi: 10.4314/ejhs.v30i5.25.

Abstract

BACKGROUND

Neuromyelitis Optica spectrum disorder is an inflammatory disorder affecting the central nervous system), most commonly attacking the spinal cord or optic nerves. Limited cases of neuromyelitis optica have been reported in east Africa. Based on my review, if published, this would be the second published case of Neuromyelitis Optica spectrum disorder and the first published case of seropositive Neuromyelitis Optica spectrum disorder reported from Ethiopia. It signifies the need to have a high index of suspicion to promptly identify and properly treat these patients.

CASE PRESENTATION

I am reporting a 32 years old female patient from Addis Ababa, Ethiopia, who presented with recurrent lower limb weakness and impairment of right eye vision of two-year duration. She was diagnosed based on Neuromyelitis Optica spectrum disorder diagnostic criteria, by having transverse myelitis, optic neuritis, confirmed by MRI imaging and high level of aquaporin-4-antibodies. Symptoms improved after providing five days of Methylprednisolone followed by low doses of corticosteroids and Azathioprine. The patient is now fully functional except for the right eye vision impairment.

CONCLUSION

The patient described here signifies a classic manifestation of Neuromylitis Optica disorder with aquaporin-4-IgG occurring in Ethiopian woman. This case highlights the existence of Devic's disease within our setting and the need to properly diagnose this condition even in a resource-limited setting to avert disability.

摘要

背景

视神经脊髓炎谱系疾病是一种影响中枢神经系统的炎症性疾病,最常侵袭脊髓或视神经。东非曾有限报道过视神经脊髓炎病例。根据我的综述,如果发表,这将是埃塞俄比亚报告的第二例发表的视神经脊髓炎谱系疾病病例,也是首例报道的血清阳性视神经脊髓炎谱系疾病病例。这表明需要高度怀疑,以便及时识别和正确治疗这些患者。

病例介绍

我报告了一位来自埃塞俄比亚亚的的斯亚贝巴的 32 岁女性患者,她因反复发作的下肢无力和右眼视力受损两年而就诊。根据视神经脊髓炎谱系疾病的诊断标准,通过磁共振成像和高水平水通道蛋白-4 抗体证实存在横贯性脊髓炎和视神经炎而做出诊断。给予五天甲基强的松龙治疗后,症状改善,随后给予低剂量皮质类固醇和硫唑嘌呤。患者除右眼视力受损外,现在功能完全正常。

结论

这里描述的患者表现出典型的视神经脊髓炎疾病表现,伴有水通道蛋白-4-IgG 阳性,发生在埃塞俄比亚女性中。该病例强调了在我们的环境中存在 Devic 病的存在,即使在资源有限的情况下,也需要正确诊断这种疾病,以避免残疾。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1371/8047278/792b46e87a92/EJHS3005-0847Fig1.jpg

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