ABSTRACT
We report a 62-year-old woman who suffered from polymyositis (PM) complicated with myasthenic crisis. Electromyography and muscle biopsy indicated a diagnosis of PM; however, respiratory failure due to respiratory muscle weakness was seen in spite of a normal serum creatine kinase (CK) level. The positive anti-acetylcholine receptor antibody led us to the diagnosis of myasthenic crisis. PM with respiratory muscle weakness is rare. We suggest that the possibility of other neurological disorder complications should be considered when PM patients have respiratory muscle weakness out of proportion to the serum CK level.
Subject(s)
Autoantibodies/adverse effects , Myasthenia Gravis/etiology , Polymyositis/complications , Receptors, Cholinergic/immunology , Respiratory Muscles/physiopathology , Female , Humans , Middle Aged , Myasthenia Gravis/therapy , Plasma Exchange , Polymyositis/therapyABSTRACT
A 24-year-old man was admitted to our hospital because of consciousness disturbance, a stiff neck and various brainstem symptoms including a right one-and-a-half syndrome and right peripheral facial palsy a week after an episode of pharyngitis and right facial herpes simplex. Magnetic resonance imaging of the brain on admission showed high-signal intensities in the right pontine tegmentum, right cerebellar peduncle and vermis on fluid-attenuated inversion recovery imaging. Examination of cerebrospinal fluid yielded mononuclear pleocytosis, elevated protein and increased IgM antibodies to herpes simplex virus (HSV) by enzyme immunoassay. HSV-1 specific antibodies also were detected in serum by neutralization test. We gave a diagnosis of brainstem encephalitis caused by HSV-1. The patient was successfully treated with high dose of acyclovir, steroid and intravenous immunoglobulin. He was discharged without any neurologic sequelae. We herein presented a case of atypical encephalitis due to HSV-1 involving mainly the brainstem with possible infection via right trigeminal nerve and summarized recent 35 cases with herpetic brainstem encephalitis since 1990.
Subject(s)
Brain Stem/pathology , Encephalitis, Herpes Simplex/diagnosis , Herpesvirus 1, Human , Magnetic Resonance Imaging , Trigeminal Nerve Diseases/virology , Acyclovir/therapeutic use , Adult , Antiviral Agents/therapeutic use , Bell Palsy/etiology , Encephalitis, Herpes Simplex/drug therapy , Humans , Male , Trigeminal Nerve Diseases/complicationsSubject(s)
Arthritis, Infectious/virology , Parvoviridae Infections/virology , Parvovirus B19, Human/immunology , Adult , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Antibodies, Viral/blood , Arthritis, Infectious/diagnosis , Arthritis, Infectious/drug therapy , Biomarkers/blood , Erythema Infectiosum/virology , Female , Humans , Immunoglobulin M/blood , Parvoviridae Infections/diagnosis , Parvoviridae Infections/drug therapy , Treatment OutcomeABSTRACT
We report a 34-year-old woman who developed primary antiphospholipid antibody syndrome (APS) presenting with dysfunctional uterine bleeding and cerebral infarction. Antiphospholipid antibody syndrome presenting with bleeding manifestations is rare. We should recognize that APS may be associated with not only thrombosis but also bleeding.
Subject(s)
Antiphospholipid Syndrome/complications , Antiphospholipid Syndrome/diagnosis , Cerebral Infarction/etiology , Metrorrhagia/etiology , Adult , Female , HumansABSTRACT
We report the case of a 63-year-old woman who suffered from mixed connective tissue disease (MCTD) complicated with thymic carcinoma and Hashimoto's thyroiditis. Although many systemic syndromes associated with thymoma and thymic carcinoma, i.e., myasthenia gravis, pure red cell aplasia, hypogammaglobulinemia, and Hashimoto's thyroiditis, are known, this is the first report of MCTD complicated with thymic carcinoma. It was suggested that MCTD may be a paraneoplastic syndrome associated with thymic carcinoma.