A case of atypical Miller Fisher syndrome associated with antiphospholipid antibodies

We report a 56-year-old man with external ophthalmoplegia and ataxic gait following a diarrhea, being diagnosed atypical Miller Fisher syndrome (FS). On admission, he had severe diplopia and bilateral external ophthalmoplegia were observed. The deep tendon reflexes were decreased on the right upper...

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Bibliographic Details
Published inRinshō shinkeigaku Vol. 39; no. 4; p. 448
Main Authors Ishida, S, Ura, M, Kameoka, K, Furukawa, K, Tagami, M
Format Journal Article
LanguageJapanese
Published Japan 01.04.1999
Subjects
Antibodies, Antiphospholipid - blood
Autoimmunity
Female
Humans
Immunoglobulin G - blood
Immunosorbent Techniques
Male
Middle Aged
Miller Fisher Syndrome - immunology
Miller Fisher Syndrome - therapy
Treatment Outcome
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Summary:We report a 56-year-old man with external ophthalmoplegia and ataxic gait following a diarrhea, being diagnosed atypical Miller Fisher syndrome (FS). On admission, he had severe diplopia and bilateral external ophthalmoplegia were observed. The deep tendon reflexes were decreased on the right upper extremity. He could not walk straight and his tandem gait was impaired. Serum IgG anticardiolipin antibody (aCL) and APTT-lupus anticoagulant (LA) were found to be increased. The serum of the patient had low titer of anti-GQ 1 b and anti-GM 1 antibodies. After the first immunoadsorption therapy, his ophthalmoplegia was improved moderately, but peripheral facial palsy appeared. He was treated with immunoadsorption again, then all neurologic symptoms improved and a follow-up study revealed normalized aCL and LA titers. There have been no previous reports of FS associated with antiphospholipid antibody. The low titer of serum anti-GQ1b and anti-GM 1 antibodies in this patient suggests that the antiphospholipid antibodies, such as aCL and LA, may be linked to the pathogenesis of FS.
ISSN:0009-918X