title: Hypothermia, hypotension, hypersomnia, and obesity associated with hypothalamic lesions in a patient positive for the anti-aquaporin 4 antibody: a case report and literature review.
abstract: OBJECTIVE
  To describe a patient positive for the anti-aquaporin 4 antibody with hypothalamic lesions showing hypothermia, hypotension, hypersomnia, and obesity.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  We describe a 21-year-old woman who was positive for anti-aquaporin 4 antibody and presented with hypothermia, hypotension, and hypersomnia owing to bilateral hypothalamic lesions as the only abnormal clinical finding.
  
  
  RESULTS
  Immediate steroid administration resulted in significant improvement of the patient's vital signs and imaging findings; however, her cognitive impairment and sleepiness persisted, and she subsequently developed obesity. Decreased cerebrospinal fluid orexin levels and sleep studies confirmed the diagnosis of narcolepsy due to medical condition. Physicians should be aware that neuromyelitis optica spectrum disorders can initially involve the hypothalamus.
  
  
  CONCLUSIONS
  We emphasize that measurement of anti-aquaporin 4 antibody is of clinical importance in the differential diagnosis of hypothalamic lesions.
authors: Department of Neurology, Dokkyo Medical University, Tochigi, Japan. keisuke@dokkyomed.ac.jp
authors: Keisuke
authors: K
authors: Suzuki
authors: Toshiki
authors: T
authors: Nakamura
authors: Kenichi
authors: K
authors: Hashimoto
authors: Masayuki
authors: M
authors: Miyamoto
authors: Tomoko
authors: T
authors: Komagamine
authors: Takahide
authors: T
authors: Nagashima
authors: Naoki
authors: N
authors: Izawa
authors: Takashi
authors: T
authors: Kanbayashi
authors: Toshiyuki
authors: T
authors: Takahashi
authors: Koichi
authors: K
authors: Hirata
mesh_terms: D000888:Antibodies, Anti-Idiotypic / Q000097:blood*; D051401:Aquaporin 4 / Q000276:immunology*; D006970:Disorders of Excessive Somnolence / Q000097:blood / Q000150:complications / Q000473:pathology; D005260:Female; D006801:Humans; D007022:Hypotension / Q000097:blood / Q000150:complications / Q000473:pathology; D007031:Hypothalamus / Q000473:pathology*; D007035:Hypothermia / Q000097:blood / Q000150:complications / Q000473:pathology; D008279:Magnetic Resonance Imaging; D009765:Obesity / Q000097:blood / Q000150:complications / Q000473:pathology; D055815:Young Adult
chemical_list: D000888:Antibodies, Anti-Idiotypic; D051401:Aquaporin 4