Immune-mediated ophthalmoparesis with anti-GD1a antibodies.
| Autor: | McKean N; Department of Neurosciences, Mater Dei Hospital, Msida, Malta norma.mckean@gov.mt.; Department of Medicine, University of Malta, Msida, Malta., Chircop C; Department of Neurosciences, Mater Dei Hospital, Msida, Malta.; Department of Medicine, University of Malta, Msida, Malta. |
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| Jazyk: | angličtina |
| Zdroj: | BMJ case reports [BMJ Case Rep] 2021 Nov 18; Vol. 14 (11). Date of Electronic Publication: 2021 Nov 18. |
| DOI: | 10.1136/bcr-2021-244273 |
| Abstrakt: | A young woman presented to neurology with a 1 month history of progressive diplopia on lateral gaze and a 1 week history of headaches. On examination she was found to have complex ophthalmoparesis with binocular horizontal diplopia, failure of abduction bilaterally and limited upgaze with convergence-retraction nystagmus. The rest of the neurological examination was normal. She was admitted for investigations: blood, CT brain, MR brain and lumbar puncture results were normal. Anti-GD1a antibodies were strongly positive; anti-GM1, anti-GM2 and anti-GD1b were also positive. On follow-up 3 weeks later, the complex ophthalmoplegia persisted. It was decided to treat with intravenous immunoglobulins (IVIgs) with good response but recurrence at 2 weeks post infusion. She was treated with 4 weekly IVIg courses and remains responsive and controlled over 1 year since presentation but becomes symptomatic in the week running up to each dose; thus, disease modifying treatment is currently being considered. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.) |
| Databáze: | MEDLINE |
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