Ikechukwu C, Onyedika M, Nwazor E, Usigbe F
Department of Internal Medicine, Federal University Teaching Hospital, Owerri, Nigeria.
Department of Medicine, University College Hospital, Ibadan, Nigeria.
Ann Ib Postgrad Med. 2025 Mar 31;23(1):89-92.
Stiff Person Syndrome (SPS) is a rare neurological disorder characterized by muscle stiffness and painful muscle spasms. The symptoms often progress slowly and can cause disability. Auto-antibodies to glutamic acid decarboxylase (anti-GAD) have been reported in up to 80% of the classic type of SPS. Delayed diagnosis may occur especially in low-resource settings if a high index of suspicion is not applied when individuals manifest characteristic symptoms. We report a case of a 63-year-old Nigerian female who presented with progressive onset low back pain, lower body rigidity and painful muscle spasm with subsequent loss of ambulation and development of depression. Serologic tests detected high-titer anti-GAD, confirming the diagnosis of SPS. Due to limited availability and the financial implications of out-of-pocket treatment, escalation therapy to immunebased therapy for this neurological disorder was hindered in our case.
僵人综合征(SPS)是一种罕见的神经系统疾病,其特征为肌肉僵硬和疼痛性肌肉痉挛。症状通常进展缓慢,可导致残疾。在高达80%的经典型SPS中已报告存在谷氨酸脱羧酶自身抗体(抗GAD)。如果在个体出现特征性症状时未保持高度怀疑,尤其是在资源匮乏地区,可能会出现诊断延迟。我们报告一例63岁尼日利亚女性病例,该患者表现为进行性发作的下背痛、下身僵硬和疼痛性肌肉痉挛,随后丧失行走能力并出现抑郁。血清学检测发现高滴度抗GAD,确诊为SPS。由于可获得性有限以及自费治疗的经济影响,在我们的病例中,针对这种神经系统疾病升级为基于免疫的治疗受到了阻碍。