Stiff-Person Syndrome: Seeing Past Comorbidities to Reach the Correct Diagnosis
Autor: | Daniel Ramirez, Mark Rigby, Aram Minasian, Jared Hicken |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Pediatrics
medicine.medical_specialty Past medical history business.industry Case Report medicine.disease 03 medical and health sciences 0302 clinical medicine Muscle Rigidity 030220 oncology & carcinogenesis Tizanidine Lactic acidosis Medicine Anxiety Neurology. Diseases of the nervous system medicine.symptom General Agricultural and Biological Sciences business RC346-429 Diazepam 030217 neurology & neurosurgery Stiff person syndrome Depression (differential diagnoses) medicine.drug |
Zdroj: | Case Reports in Neurological Medicine Case Reports in Neurological Medicine, Vol 2021 (2021) |
ISSN: | 2090-6676 2090-6668 |
Popis: | Stiff-person syndrome (SPS) is a rare disorder seen in approximately one in one million people. Although it is rare, the symptoms and findings of a typical case should paint a clear clinical picture for those who are familiar with the disease. The primary findings in SPS include progressive axial muscle rigidity as well as muscle spasms. These symptoms most commonly occur in the setting of antibodies against Glutamic Acid Decarboxylase (GAD), the rate-limiting enzyme in the production of Gamma-Aminobutyric Acid (GABA), which is the primary inhibitory enzyme in the central nervous system. Here, we report the case of a 65-year-old African-American female with a past medical history of hypothyroidism, anxiety, and depression with psychotic features who presented with axial muscle rigidity and lactic acidosis. She had been symptomatic for several months and reported extensive workups performed at two previous hospitals without a definitive diagnosis. A complete neurological and musculoskeletal investigation yielded no positive findings except for the presence of GAD antibodies. The patient was treated with diazepam, tizanidine, and Intravenous Immunoglobulin (IVIG) with significant improvement, thus solidifying the diagnosis of SPS, a rare autoimmune and/or paraneoplastic syndrome. |
Databáze: | OpenAIRE |
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