The Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Huichuan District, Zunyi City, Guizhou Province, China.
BMC Neurol. 2024 Aug 28;24(1):300. doi: 10.1186/s12883-024-03775-0.
Motor neuron disease (MND) is a chronic and progressive neurodegenerative disorder with an unknown cause. The development of amyotrophic lateral sclerosis (ALS) is believed to be linked to an immune response. Monocytes/macrophages and T cells are key players in the disease's advancement. Monitoring levels of cytokines in the blood can help forecast patient outcomes, while immunotherapy shows promise in alleviating symptoms for certain individuals.
A 56-year-old male patient was admitted to the hospital due to progressive limb weakness persisting for eight months. The neurological examination revealed impairments in both upper and lower motor neurons, as well as sensory anomalies, without corresponding signs. Electrophysiological examination results indicated extensive neuronal damage and multiple peripheral nerve impairments, thereby the diagnosis was ALS. One month ago, the patient began experiencing symptoms of dry mouth and a bitter taste. Following tests for rheumatic immune-related antibodies and a lip gland biopsy, a diagnosis of Sjögren's syndrome (SS) was proposed. Despite treatment with medications such as hormones (methylprednisolone), immunosuppressants (hydroxychloroquine sulfate), and riluzole, the symptoms did not significantly improve, but also did not worsen.
It is recommended to include screening for SS in the standard assessment of ALS. Furthermore, research should focus on understanding the immune mechanisms involved in ALS, providing new insights for the diagnosis and treatment of ALS in conjunction with SS.
运动神经元病(MND)是一种病因不明的慢性进行性神经退行性疾病。肌萎缩侧索硬化症(ALS)的发展被认为与免疫反应有关。单核细胞/巨噬细胞和 T 细胞是疾病进展的关键因素。监测血液中的细胞因子水平有助于预测患者的预后,而免疫疗法在缓解某些患者的症状方面显示出前景。
一名 56 岁男性患者因持续 8 个月的进行性肢体无力入院。神经系统检查显示上下运动神经元受损,伴有感觉异常,但无相应体征。电生理学检查结果表明广泛的神经元损伤和多发性周围神经损伤,因此诊断为 ALS。一个月前,患者开始出现口干和口苦的症状。风湿免疫相关抗体及唇腺活检检查后,诊断为干燥综合征(SS)。尽管使用激素(甲泼尼龙)、免疫抑制剂(硫酸羟氯喹)和利鲁唑等药物治疗,但症状没有明显改善,也没有恶化。
建议将 SS 的筛查纳入 ALS 的标准评估中。此外,应研究重点放在理解 ALS 中的免疫机制上,为 ALS 与 SS 的诊断和治疗提供新的见解。