[The detection of anti-cerebellar antibody western blot analysis in serum from a patient with Miller Fisher syndrome].
We here report a case of Miller Fisher syndrome (MFS) in which serum anti-cerebellar antibody was detected by Western blot analysis. The 32-year-old male studied suffered from diplopia, gait ataxia and sensory disturbance in the distal portion of the upper limbs preceded by cold-like symptoms. Neurological examination on admission revealed that he had external ophthalmoplegia with bilateral ptosis, cerebellar ataxia and areflexia. A cerebrospinal fluid examination showed albuminocytologic dissociation with a protein concentration of 60 mg/dl. Brain CT and MRI showed no significant abnormalities. The patient was diagnosed as MFS, and treated it with two sessions of immunoadsorption plasmapheresis (IAPP). After receiving IAPP therapy, the patient's neurological symptoms and signs were improved. Western blot analysis showed the existence of antibody directed against mouse cerebellum but not against mouse cerebrum, brain stem, and spinal cord in his serum, the level of which was decreased after the IAPP therapy. Serum anti-GQ1b antibody was also elevated. As far as we are aware, there have been no reports showing the existence of anti-cerebellar antibodies detected by Western blot analysis. Though the pathogenesis of MFS remains unclear, our findings suggest that anti-cerebellar antibody detected by Western blot analysis may be caused by cerebellar ataxia in MFS.
Department of Internal Medicine, School of Medicine, Shinshu University.
T
T
Iwahashi
A
A
Inoue
S
S
Koh
N
N
Yanagihara
D000328:Adult; D000818:Animals; D001323:Autoantibodies / Q000097:blood*; D015153:Blotting, Western; D002524:Cerebellar Ataxia / Q000276:immunology*; D002531:Cerebellum / Q000276:immunology*; D006801:Humans; D008297:Male; D051379:Mice; D009886:Ophthalmoplegia / Q000276:immunology*; D011129:Polyradiculoneuropathy / Q000276:immunology; D012021:Reflex, Abnormal / Q000276:immunology; D012026:Reflex, Stretch; D013577:Syndrome
D001323:Autoantibodies