RESUMO
Malignant lymphoma sometimes involves peripheral nerves due to paraneoplastic syndrome associated with anti-ganglioside antibodies. We report a very rare case of malignant lymphoma accompanied by an asymmetrical and isolated hypoglossal nerve palsy associated with a new subset of anti-ganglioside antibodies. Magnetic resonance imaging and 18F-2-deoxy-2-fluoro-D-glucose position emission tomography showed no abnormalities of the hypoglossal nerve nucleus; however, the patient' s serum was positive for anti-sulfated glucuronyl paragloboside IgM antibodies as well as anti-GM1 IgM and anti-GQ1b IgM antibodies. The present case might suggest a paraneoplastic asymmetrical and isolated hypoglossal nerve palsy associated with a new subset of anti-ganglioside antibodies.
Assuntos
Gangliosídeo G(M1)/imunologia , Globosídeos/imunologia , Doenças do Nervo Hipoglosso/etiologia , Imunoglobulina M/sangue , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/imunologia , Idoso , Fluordesoxiglucose F18 , Humanos , Doenças do Nervo Hipoglosso/diagnóstico por imagem , Doenças do Nervo Hipoglosso/imunologia , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Compostos Radiofarmacêuticos , Tomografia Computadorizada por Raios XAssuntos
Doenças Desmielinizantes , Doenças do Nervo Hipoglosso , Polineuropatias , Adulto , Doenças Desmielinizantes/complicações , Doenças Desmielinizantes/diagnóstico , Doenças Desmielinizantes/imunologia , Doenças Desmielinizantes/fisiopatologia , Feminino , Humanos , Doenças do Nervo Hipoglosso/etiologia , Doenças do Nervo Hipoglosso/imunologia , Doenças do Nervo Hipoglosso/fisiopatologia , Polineuropatias/complicações , Polineuropatias/diagnóstico , Polineuropatias/imunologia , Polineuropatias/fisiopatologiaRESUMO
A 60-year-old man presented with acute onset of left hemiparesis and left hypoglossal nerve palsy with ipsilateral tongue swelling. He then progressed to tetraparesis in a few days. Cerebrospinal fluid showed cell protein dissociation. A nerve conduction study showed motor axonal neuropathy with sensory sparing. A subsequent blood test revealed anti-GD1b IgG antibody positivity. He was diagnosed to have acute motor axonal neuropathy (AMAN) and treated with a course of intravenous immunoglobulin with slow improvement. This is probably the first AMAN with asymmetrical presentation mimicking stroke reported in the literature in detail. The anti-GD1b IgG antibody is also not commonly associated with AMAN.