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急性发作的慢性炎症性脱髓鞘性多发性神经病伴抗 GM3 和抗硫酸酯抗体检测的罕见表现:一例报告。

A rare presentation of acute-onset chronic inflammatory demyelinating polyneuropathy with the detection of anti-GM3 and anti-sulfatides antibodies: a case report.

机构信息

Department of Neurology, Hebei General Hospital, Shijiazhuang, China.

Department of Neurology, Hebei Medical University, Shijiazhuang, Hebei, China.

出版信息

Front Immunol. 2024 Jul 15;15:1409637. doi: 10.3389/fimmu.2024.1409637. eCollection 2024.

Abstract

OBJECTIVES

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired immune-mediated neuropathy defined by clinical progression for more than 2 months. 16-20% of CIDP patients may present with rapidly progressive weakness that resembles GBS, known as acute-onset CIDP (A-CIDP). However, it is challenging to distinguish from GBS-TRF because of their similar clinical symptom and features. In this case review, we report a patient with A-CIDP with the detection of anti-GM3 and anti-sulfatides antibodies, which rarely have been in A-CIDP and may account for her progressive and recurrent symptoms.

METHODS

We analyzed existing medical literature and described a clinical case of A-CIDP with antibodies positive.

RESULTS

We reported a 56-year-old female presented with bilateral lower extremity weakness and distal numbness. She experienced similar symptoms four times and responded well to the IVIg therapy. Lumbar puncture demonstrated albumin-cytologic dissociation and EDX examination revealed multiple peripheral nerve damage. After ruling out other demyelination diseases, a diagnosis of A-CIDP was made.

DISCUSSION

The antiganglioside and anti-sulfatide antibodies are involved in CIDP pathogenesis and can help to distinguish A-CIDP and other variants. To prevent secondary damage, it is important to monitor relapse and remission symptoms along the treatment line. A rare case of A-CIDP is discussed concerning the detection of anti-GM3 and anti-sulfatides antibodies, thus making a retrospective comparison of antibodies in some literature to understand A-CIDP better.

摘要

目的

慢性炎症性脱髓鞘性多发性神经病(CIDP)是一种获得性免疫介导的神经病,其定义为临床进展超过 2 个月。16%-20%的 CIDP 患者可能出现类似于 GBS 的迅速进展性无力,称为急性发作性 CIDP(A-CIDP)。然而,由于其相似的临床症状和特征,与 GBS-TRF 很难区分。在本病例回顾中,我们报告了一例 A-CIDP 患者,检测到抗 GM3 和抗硫酸盐抗体,这在 A-CIDP 中很少见,可能是导致其进行性和复发性症状的原因。

方法

我们分析了现有的医学文献,并描述了一例抗体阳性的 A-CIDP 临床病例。

结果

我们报告了一例 56 岁女性,表现为双侧下肢无力和远端麻木。她经历了类似的症状四次,对 IVIg 治疗反应良好。腰椎穿刺显示白蛋白-细胞分离,EDX 检查显示多发性周围神经损伤。排除其他脱髓鞘疾病后,诊断为 A-CIDP。

讨论

抗神经节苷脂和抗硫酸盐抗体参与 CIDP 的发病机制,有助于区分 A-CIDP 和其他变体。为了防止继发性损伤,重要的是沿着治疗线监测复发和缓解症状。我们讨论了一例罕见的 A-CIDP 病例,涉及抗 GM3 和抗硫酸盐抗体的检测,从而对一些文献中的抗体进行回顾性比较,以更好地了解 A-CIDP。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d33d/11284090/6c47f2f631dc/fimmu-15-1409637-g001.jpg

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