[1]李明霞,周琼,郭荣静,等.抗GM2神经节苷脂抗体综合征3例临床特点及文献复习[J].卒中与神经疾病杂志,2024,31(06):573-576582.[doi:10.3969/j.issn.1007-0478.2024.06.012]
点击复制

抗GM2神经节苷脂抗体综合征3例临床特点及文献复习()
分享到:

《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第31卷
期数:
2024年06期
页码:
573-576582
栏目:
论著
出版日期:
2024-12-20

文章信息/Info

文章编号:
1007-0478(2024)06-0573-05
作者:
李明霞周琼郭荣静葛芳芳林宏石剑宽
710100 西安国际医学中心医院神经内科[李明霞 周琼 葛芳芳 林宏 石剑宽(通信作者)]; 空军军医大学唐都医院神经内科(郭荣静)
关键词:
抗单唾液酸神经节苷脂GM2抗体 神经节苷脂抗体 巨细胞病毒
分类号:
R741
DOI:
10.3969/j.issn.1007-0478.2024.06.012
文献标志码:
A
摘要:
目的 总结3例抗GM2单唾液酸神经节苷脂抗体综合症患者的临床表现、实验室检查及预后。方法 收集本院2017年1月-2018年12月诊断为抗GM2神经节苷脂抗体综合征的3例患者的临床资料,回顾分析患者临床特征、实验室检查及影像学检查特点。结果 3例抗GM2-IgG抗体阳性患者中男性2例,年龄52~67岁; 1例有前驱感染史; 2例以头晕起病,1例为头晕伴眼外肌麻痹,另1例表现为头晕伴共济失调,1例表现为双侧周围性面瘫; 3例患者脑脊液白细胞数均正常,3例患者均无脑脊液蛋白-细胞分离; 1例患者发病后头颅核磁共振提示右侧桥臂异常信号影; 2例患者合并桥本氏甲状腺炎; 1例患者合并有抗GM4-IgG抗体阳性; 3例患者接受激素治疗后症状均有缓解。结论 临床表现为孤立性头晕、共济失调、双侧周围性面瘫的患者,应考虑到抗神经节苷脂抗体检测的必要性。

参考文献/References:

[1] Piccinini M,Scandroglio F,Prioni S,et al.Deregulated sphingolipid metabolism and membrane organization in neurodegenerative disorders[J].Mol Neurobiol,2010,41(2/3):314-340.
[2] Sastry PS.Lipids of nervous tissue: composition and metabolism[J].Prog Lipid Res,1985,24(2):69-176.
[3] Tettamanti G.Ganglioside/glycosphingolipid turnover: new concepts[J].Glycoconj J,2004,20(5):301-317.
[4] Kolter T.Ganglioside biochemistry[J].ISRN Biochem,2012:506160.
[5] Rupp A,Galban-Horcajo F,Bianchi E,et al.Anti-GM2 ganglioside antibodies are a biomarker for acute canine polyradiculoneuritis[J].J Peripher Nerv Syst,2013,18(1):75-88.
[6] O'Hanlon GM,Veitch J,Gallardo E,et al.Peripheral neuropathy associated with anti-GM2 ganglioside antibodies: clinical and immunopathological studies[J].Autoimmunity,2000,32(2):133-144.
[7] Yuki N,Tagawa Y.Acute cytomegalovirus infection and IgM anti-GM2 antibody[J].J Neurol Sci,1998,154(1):14-17.
[8] Kim JK,Kim YH,Yoon BA,et al.Clinical heterogeneity of anti-GM2-ganglioside-antibody syndrome[J].J Clin Neurol,2018,14(3):401-406.
[9] Vorwerk CK.Ganglioside patterns in human spinal cord[J].Spinal Cord,2001,39(12):628-632.
[10] Kishi M,Sakakibara R,Ogawa E,et al.Bilateral abducens palsy in a case of cytomegalovirus-associated Guillain-Barré syndrome[J].Neurol Sci,2011,32(6):1219-1222.
[11] Vachalová I,Golden V,Heckmann JG.Anti-GM2, -GD1a and -GD1b positive purely isolated facial diplegia[J].Clin Neurol Neurosurg,2014,122:131-132.
[12] Smyth KA,Fritzler MJ,Kirton A.Acquired infantile abducens palsy associated with anti-GM2 antibodies[J].Pediatr Neurol,2011,44(6):459-462.
[13] Silva CT,Silva S,Silva MJ,et al.Guillain-Barré syndrome in a teenage girl: a severe case with anti-GM2 antibodies associated with acute CMV infection and literature review[J].Clin Pediatr(Phila),2020,59(3):300-304.
[14] Spagnoli C, Iodice A, Salerno G G,et al.CMV-associated axonal sensory-motor Guillain-Barré syndrome in a child: case report and review of the literature[J].European journal of paediatric neurology: EJPN: official journal of the european paediatric neurology society, 2016, 20(1).DOI:10.1016/j.ejpn.2015.11.004.
[15] Tsukaguchi M,Tagawa Y,Takeuchi H,et al.IgM anti-GM2 antibody in a patient with Guillain-Barré syndrome subsequent to cytomegalovirus hepatitis cross reacts with N-acetylgalactosaminyl GD1a[J].J Neurol Neurosurg Psychiatry,1998,65(3):407-408.
[16] Weiss MD,Luciano CA,Semino-Mora C,et al.Molecular mimicry in chronic inflammatory demyelinating polyneuropathy and melanoma[J].Neurology,1998,51(6):1738-1741.
[17] Lopate G,Choksi R,Pestronk A.Severe sensory ataxia and demyelinating polyneuropathy with IgM anti-GM2 and GalNAc-GD1A antibodies[J].Muscle Nerve,2002,25(6):828-836.
[18] Cronin S,McNicholas R,Kavanagh E,et al.Anti-glycolipid GM2-positive Guillain-Barre syndrome due to hepatitis E infection[J].Ir J Med Sci,2011,180(1):255-257.
[19] Santos García D,Llaneza M,Macias M,et al.Multiple cranial neuropathy associated with herpes simplex virus infection and anti-GM2 immunoglobulin M antibodies[J].J Clin Neuromuscul Dis,2009,10(4):199-201.
[20] 刘勇,赵代弟,张敏,等.抗GM2抗体阳性的脑干脑炎一例[J].中华神经科杂志,2016,49(9):716-717.
[21] Irie S,Saito T,Nakamura K,et al.Association of anti-GM2 antibodies in Guillain-Barré syndrome with acute cytomegalovirus infection[J].J Neuroimmunol,1996,68(1/2):19-26.
[22] Ang CW,Jacobs BC,Brandenburg AH,et al.Cross-reactive antibodies against GM2 and CMV-infected fibroblasts in Guillain-Barré syndrome[J].Neurology,2000,54(7):1453-1458.
[23] Neil J,Choumet V,Le Coupanec A,et al.Guillain-Barre syndrome: first description of a snake envenomation aetiology[J].J Neuroimmunol,2012,242(1/2):72-77.

备注/Memo

备注/Memo:
基金项目:陕西省自然科学基础研究计划项目(编号为S2022-JC-QN-2414); 国家自然科学基金资助项目(编号为81960189)
更新日期/Last Update: 2024-12-20