Chronic progressive sensory ataxic neuropathy associated with limited systemic sclerosis.
We report the case of a 33-year-old woman with limited systemic sclerosis and chronic progressive sensory ataxic neuropathy. Sural nerve biopsy showed loss of myelinated fibers mostly those of large diameter, axonal degeneration and infiltration of macrophages, but no signs of vasculitis. Physical examination, laboratory testing, neurophysiological and neuroradiological examinations suggested that the dorsal root was primarily affected in this patient. Cytokine analysis by multiplex bead array assay revealed that IL-1beta and GM-CSF were increased both in serum and CSF. Although her symptoms did not respond to corticosteroid therapy, intravenous immunoglobulin (IVIg) therapy resulted in marked improvement. IVIg could be effective in case of immune-mediated reversible neuronal dysfunction associated with collagen disease without vasculitis.
Nobuhara
Yasuyuki
Y
Department of Neurology and Respiratory Disease, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan. nbh@m.kufm.kagoshima-u.ac.jp
Saito
Mineki
M
Goto
Rina
R
Yoshidome
Yoshihito
Y
Kawamura
Miwako
M
Kasai
Takefumi
T
Higashimoto
Ikkou
I
Eiraku
Nobutaka
N
Umehara
Fujio
F
Osame
Mitsuhiro
M
Arimura
Kimiyoshi
K
D000328:Adult; D001259:Ataxia / Q000150:complications* / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D016207:Cytokines / Q000378:metabolism; D003711:Demyelinating Diseases / Q000150:complications / Q000473:pathology / Q000628:therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D010523:Peripheral Nervous System Diseases / Q000150:complications* / Q000473:pathology / Q000628:therapy; D012678:Sensation Disorders / Q000150:complications* / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D013497:Sural Nerve / Q000473:pathology / Q000648:ultrastructure
D016207:Cytokines