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.

Keisuke Suzuki, Toshiki Nakamura, Kenichi Hashimoto, Masayuki Miyamoto, Tomoko Komagamine, Takahide Nagashima, Naoki Izawa, Takashi Kanbayashi, Toshiyuki Takahashi, Koichi Hirata
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引用次数: 62

Abstract

Objective: To describe a patient positive for the anti-aquaporin 4 antibody with hypothalamic lesions showing hypothermia, hypotension, hypersomnia, and obesity.

Design: Case report.

Setting: University hospital.

Patient: 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.

抗水通道蛋白4抗体阳性患者的低温、低血压、嗜睡和肥胖与下丘脑病变相关:1例报告和文献综述
目的:描述一名抗水通道蛋白4抗体阳性的患者,其下丘脑病变表现为体温过低、低血压、嗜睡和肥胖。设计:病例报告。单位:大学医院。患者:我们描述了一名21岁的女性,她抗水通道蛋白4抗体阳性,由于双侧下丘脑病变而表现为体温过低、低血压和嗜睡,这是唯一的异常临床表现。结果:立即给予类固醇治疗可显著改善患者的生命体征和影像学表现;然而,她的认知障碍和嗜睡持续存在,随后她患上了肥胖症。脑脊液食欲素水平下降和睡眠研究证实了由于医疗条件导致的发作性睡病诊断。医生应该意识到视神经脊髓炎谱系障碍最初可累及下丘脑。结论:我们强调抗水通道蛋白4抗体的测定对下丘脑病变的鉴别诊断具有重要的临床意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Archives of neurology
Archives of neurology 医学-临床神经学
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