Musa Juna, Rahman Masum, Siddik Abu Bakar, Saliaj Kristi, Ikram Samar, Kola Ina, Shoushtarizadeh Alireza, Guy Ali, Mamica Inva, Rahman Abdur, Ahsan Eram, Cobo Anisa, Blanco Ruben
Department of General Surgery, Mayo Clinic, Rochester, MN, USA.
Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA.
Radiol Case Rep. 2021 Aug 26;16(11):3176-3181. doi: 10.1016/j.radcr.2021.07.067. eCollection 2021 Nov.
Parsonage-Turner Syndrome (PTS), also known as brachial neuritis or neuralgic amyotrophy, is a rare disorder affecting 2 to 3 individuals per 100,000 each year. Abrupt onset shoulder pain, followed by motor weakness, paresthesia and hypoesthesia, is usually reported, lasting several months with variable recovery. The etiology of the disease may be idiopathic or triggered by an underlying autoimmune disease in genetically susceptible individuals. Our report addresses a unique case of Parsonage-Turner Syndrome in a patient suffering from concurrent Hashimoto Thyroiditis. A previously healthy A 22 year-old female was referred to the Department of Neurology after complaints of sudden-onset motor weakness in her left upper limb. On physical examination, the patient could not make an "Ok sign" with her thumb and distal phalanx or form a complete fist, revealing weakness within the anterior interosseous branch of the median nerve. Further testing with electromyography demonstrated muscular atrophy within the arm's anterior compartment, forearm, and triceps brachii of the posterior compartment. Additional imaging and physical examination were unremarkable, confirming our diagnosis of PTS. Furthermore, lab reports revealed elevated levels of anti-thyroglobulin and anti-thyroid peroxidase antibodies and our patient was concurrently diagnosed with Hashimoto's thyroiditis. This case aims to highlight the rare co-occurrence of Hashimoto's thyroiditis with Parsonage-Turner Syndrome in an otherwise healthy patient. A 2014 study published by Nugent et al. had also shed light on brachial neuritis in a patient suffering from autoimmune connective tissue disease, and through this case study, we hope to add to the growing literature regarding the correlation between PTS and autoimmune diseases. Symptoms of PTS can easily be misdiagnosed given its similarity to other peripheral neuropathies, and careful assessment and thorough understanding of the disease is required to successfully distinguish it from other neurological pathologies.
帕森吉-特纳综合征（PTS），也称为臂神经炎或神经性肌萎缩，是一种罕见疾病，每年每10万人中有2至3人患病。通常报告为突发肩部疼痛，随后出现运动无力、感觉异常和感觉减退，持续数月，恢复情况不一。该疾病的病因可能是特发性的，或由遗传易感性个体中的潜在自身免疫性疾病引发。我们的报告讲述了一例患有桥本甲状腺炎的帕森吉-特纳综合征的独特病例。一名22岁的既往健康女性因左上肢突发运动无力前来就诊，被转诊至神经内科。体格检查时，患者无法用拇指和远节指骨做出“OK”手势，也无法形成完整的拳头，提示正中神经骨间前支存在无力。进一步的肌电图检查显示，手臂前侧肌间隔、前臂以及后侧肌间隔的肱三头肌存在肌肉萎缩。额外的影像学检查和体格检查无异常，证实了我们对PTS的诊断。此外，实验室报告显示抗甲状腺球蛋白和抗甲状腺过氧化物酶抗体水平升高，我们的患者同时被诊断为桥本甲状腺炎。本病例旨在强调在一名原本健康的患者中，桥本甲状腺炎与帕森吉-特纳综合征罕见的同时发生情况。2014年Nugent等人发表的一项研究也揭示了一名患有自身免疫性结缔组织病患者的臂神经炎情况，通过本病例研究，我们希望为关于PTS与自身免疫性疾病之间相关性的不断增加的文献做出贡献。鉴于PTS的症状与其他周围神经病变相似，很容易被误诊，因此需要仔细评估并全面了解该疾病，才能成功将其与其他神经病理学疾病区分开来。
