title: Proteinase 3-antineutrophil cytoplasmic antibody-positive ulcerative colitis presenting with abducens neuropathy.
abstract: A 72-year-old man with ulcerative colitis (UC) presented with complete left abducens nerve palsy. Although MRI showed no significant changes, cerebrospinal fluid analysis revealed pleocytosis and elevated protein and interleukin (IL)-6 levels. His serum proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA) level was also elevated to 31.1 U/mL, but granulomatosis with polyangiitis was not observed. On the basis of the diagnosis of autoimmune cranial neuropathy, he was treated with steroid therapy. While tapering steroid therapy, his serum PR3-ANCA levels; cerebrospinal fluid findings, including IL-6 levels; and symptoms improved. Serum PR3-ANCA could be a useful parameter of neurological disorders associated with ANCA-positive UC.
authors.affiliation: Department of Neurology, Seirei Hamamatu General Hospital, Hamamatsu, Shizuoka, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kirito
authors.affiliation: Department of Neurology, Seirei Hamamatu General Hospital, Hamamatsu, Shizuoka, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yamamoto
authors.affiliation: Department of Neurology, Seirei Hamamatu General Hospital, Hamamatsu, Shizuoka, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Uchiyama
mesh_terms: D020434:Abducens Nerve Diseases / Q000188:drug therapy / Q000209:etiology*; D000359:Aftercare; D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000378:metabolism*; D003093:Colitis, Ulcerative / Q000150:complications* / Q000276:immunology; D006801:Humans; D007262:Infusions, Intravenous; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D053146:Myeloblastin / Q000276:immunology*; D018696:Neuroprotective Agents / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; C508600:IL6 protein, human; D015850:Interleukin-6; D018696:Neuroprotective Agents; D053146:Myeloblastin; D008775:Methylprednisolone