RESUMO
We herein present the case of a 38-year-old woman with left-sided oculomotor paralysis with ocular pain that developed after a respiratory infection. Her serum was positive for IgM against GM2 and GalNAc-GD1a gangliosides and cytomegalovirus. Thin-slice magnetic resonance imaging revealed enhanced abnormal tissue located primarily in the superolateral part of the left-sided cavernous sinus, which corticosteroids subsequently obscured with immediate resolution of the patient's ocular symptoms. These clinical features were consistent with those of Tolosa-Hunt syndrome (THS). Our findings in the present patient suggest that cytomegalovirus may provoke granuloma formation in the cavernous sinus, as reported in other various organs, thereby leading to the development of THS.
Assuntos
Infecções por Citomegalovirus/complicações , Citomegalovirus/patogenicidade , Infecções Respiratórias/complicações , Síndrome de Tolosa-Hunt/etiologia , Adulto , Anticorpos Antivirais/sangue , Autoanticorpos/sangue , Autoanticorpos/imunologia , Seio Cavernoso/virologia , Citomegalovirus/imunologia , Infecções por Citomegalovirus/imunologia , Diplopia/etiologia , Feminino , Gangliosídeo G(M1)/análogos & derivados , Gangliosídeo G(M1)/imunologia , Gangliosídeo G(M2)/imunologia , Granuloma/etiologia , Granuloma/virologia , Humanos , Imageamento Tridimensional , Imunocompetência , Imunoglobulina M/sangue , Macrófagos/imunologia , Macrófagos/patologia , Imageamento por Ressonância Magnética , Prednisolona/uso terapêutico , Infecções Respiratórias/imunologia , Infecções Respiratórias/virologia , Síndrome de Tolosa-Hunt/tratamento farmacológico , Síndrome de Tolosa-Hunt/imunologia , Síndrome de Tolosa-Hunt/patologia , Síndrome de Tolosa-Hunt/virologiaRESUMO
Tolosa-Hunt syndrome is a steroid responsive painful opthalmoplegia due to a nonspecific inflammation of the cavernous sinus. Autoimmune hemolytic anemia is caused by antibodies directed against unmodified autologous red cells. They are both rare conditions. Here we describe the simultaneous occurrence of Tolosa-Hunt syndrome and severe hemolytic crisis in the same patient.