title: Chronic progressive sensory ataxic neuropathy associated with limited systemic sclerosis.
abstract: 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.
authors.affiliation: Department of Neurology and Respiratory Disease, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan. nbh@m.kufm.kagoshima-u.ac.jp
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Nobuhara
authors.forename: Mineki
authors.initials: M
authors.lastname: Saito
authors.forename: Rina
authors.initials: R
authors.lastname: Goto
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Yoshidome
authors.forename: Miwako
authors.initials: M
authors.lastname: Kawamura
authors.forename: Takefumi
authors.initials: T
authors.lastname: Kasai
authors.forename: Ikkou
authors.initials: I
authors.lastname: Higashimoto
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Eiraku
authors.forename: Fujio
authors.initials: F
authors.lastname: Umehara
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Osame
authors.forename: Kimiyoshi
authors.initials: K
authors.lastname: Arimura
mesh_terms: 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
chemical_list: D016207:Cytokines