Nakamura A, Masayuki M, Hashimoto T, Koh C S, Yanagisawa N, Nakano T
Department of Medicine (Neurology), Shinshu University School of Medicine.
Rinsho Shinkeigaku. 1993 May;33(5):565-7.
A 39-year-old man was admitted to our hospital because of diplopia, dysphagia, tetraparesis and urinary incontinence which developed six days after fever and general cutaneous rash had appeared. On neurological examination, total ophthalmoplegia, blepharoptosis, facial nerve palsy, bulbar palsy, and tetraparesis were observed, and the deep tendon reflexes were hypoactive or absent. The cerebrospinal fluid (CSF) showed albumin-cytological dissociation. serial complement fixation tests and enzyme-linked immunosorbent assays showed an elevation of antibody titers to measles virus in sera and CSF including serum IgM antibody. On the basis of findings, we diagnosed him as acute polyradiculoneuropathy following measles infection. After 3 sessions of immunoadsorption plasmapheresis his symptoms improved promptly. Marked improvement by immunoadsorption plasmapheresis suggested that immune-mediated mechanisms were involved in the pathogenesis of acute polyradiculoneuropathy following measles infection.
一名39岁男性因发热和全身皮疹出现六天后出现复视、吞咽困难、四肢轻瘫和尿失禁而入院。神经系统检查发现完全性眼肌麻痹、上睑下垂、面神经麻痹、延髓麻痹和四肢轻瘫，深部腱反射减弱或消失。脑脊液显示蛋白细胞分离。连续补体结合试验和酶联免疫吸附测定显示血清和脑脊液中针对麻疹病毒的抗体滴度升高，包括血清IgM抗体。根据这些发现，我们诊断他为麻疹感染后急性多发性神经根神经病。经过3次免疫吸附血浆置换治疗后，他的症状迅速改善。免疫吸附血浆置换治疗带来的显著改善表明免疫介导机制参与了麻疹感染后急性多发性神经根神经病的发病过程。
