A case of recurrent Miller-Fisher syndrome with multiple anti-ganglioside antibodies
10.3760/cma.j.cn101721-20221104-000509
- VernacularTitle:多重抗神经节苷脂抗体阳性的复发型米勒-费希尔综合征1例
- Author:
Yuanyuan YE
1
;
Zhiyan TIAN
;
Pan WANG
;
Huihong ZHANG
;
Yuying ZHOU
;
Pan LI
Author Information
1. 天津市环湖医院神经内科，天津 300350
- Keywords:
Guillain-Barré syndrome;
Recurrent Miller-Fisher syndrome;
Anti-ganglioside antibodies;
Anti-GQ1b antibody
- From:
Clinical Medicine of China
2023;39(1):57-60
- CountryChina
- Language:Chinese
-
Abstract:
Guillain-Barré syndrome (GBS) defines a kind of Immune-mediated acute inflammatory peripheral neuropathy. Miller-Fisher Syndrome (MFS) is a special variant of GBS, with mostly one-way course and rare clinical recurrence. Only a few recurrent cases have been reported in China. Here we report a case of a young male patient with double vision and progressive aggravation of limb numbness, acute onset, with symptoms of upper respiratory tract infection before onset, accompanied by pupil abnormalities and autonomic nervous dysfunction, who was was admitted to our hospital for similar symptoms 3 years ago and was improved by immunotherapy. The patient had a triad of “ataxia, areflexia and ophthalmoplegia”. Cerebrospinal fluid showed protein-cell separation. Serum anti-Sulfatides antibody IgM, anti-GT1a antibody IgG, anti-GQ1b antibody IgG and anti-GM3 IgM were positive. Recurrent MFS was diagnosed and the symptoms improved after immunotherapy. This case suggests that MFS is clinically heterogeneous, a few patients can present with relapse and generally have a better prognosis with immunotherapy. Pre-existing infection and anti-GQ1b antibody production may be predisposing factors for MFS recurrence.
