美容用肉毒杆菌毒素可能引起急性脱髓鞘性脑病伴抗乙酰胆碱受体抗体阳性:1例报告及文献复习。

IF 0.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Neuro endocrinology letters Pub Date : 2022-11-30

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引用次数: 0

摘要

背景:A型肉毒毒素(BTxA)注射后继发免疫反应的报道较少。迄今为止，还没有报道肉毒毒素诱导的脱髓鞘性脑病伴抗乙酰胆碱受体抗体(anti-AChR Ab)阳性。病例介绍:一名40岁的女性在使用低剂量肉毒毒素注射面部拉皮40天后出现急性脱髓鞘性脑病。脱髓鞘发病前一周，患者出现病毒感染等症状。血清免疫学检查显示抗achr抗体IgG (0.47 g/L)轻微升高，酶联免疫吸附测定法定量。磁共振成像显示双侧脑白质多发垂直于侧脑室的异常信号。结论:该临床特征提示BTxA浸润和脱髓鞘性脑病可能存在致病性免疫反应。基于肉毒毒素的免疫风险，低剂量的化妆品使用也应谨慎考虑，特别是那些有潜在免疫功能障碍或病毒感染史的人。

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Acute Demyelinating Encephalopathy with Positive Anti-acetylcholine Receptor Antibody Possibly after Cosmetic Use of Botulinum Toxin: A Case Report and Literature Review.

Background: Few articles have reported the immune reaction secondary to botulinum toxin type A (BTxA) injection. To date, no data have reported BTxA-induced demyelinating encephalopathy with positive anti-acetylcholine receptor antibody (anti-AChR Ab).

Case presentation: A 40-year-old woman developed an acute demyelinating encephalopathy 40 days after cosmetic use of low-dose BTxA injection for face lift. One week before the onset of demyelination, she manifested syndromes such as viral infection. Serum immunological examination revealed a slightly increased anti-AChR Ab IgG (0.47 g/L), quantified by an enzyme-linked immunosorbent assay. Magnetic resonance imaging (MRI) showed multiple abnormal signals perpendicular to the lateral ventricle in bilateral whiter matter.

Conclusions: This clinical profile suggests a possible pathogenic immunoreaction of BTxA infiltration and demyelinating encephalopathy. Based on the immune risk of BTxA, low-dose cosmetic use should also be considered prudently, particularly those who have potential immunologic dysfunction or history of viral infection.

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来源期刊

Neuro endocrinology letters 医学-内分泌学与代谢

CiteScore

1.00

自引率

14.30%

发文量

审稿时长

6 months

期刊介绍： Neuroendocrinology Letters is an international, peer-reviewed interdisciplinary journal covering the fields of Neuroendocrinology, Neuroscience, Neurophysiology, Neuropsychopharmacology, Psychoneuroimmunology, Reproductive Medicine, Chronobiology, Human Ethology and related fields for RAPID publication of Original Papers, Review Articles, State-of-the-art, Clinical Reports and other contributions from all the fields covered by Neuroendocrinology Letters. Papers from both basic research (methodology, molecular and cellular biology, anatomy, histology, biology, embryology, teratology, normal and pathological physiology, biophysics, pharmacology, pathology and experimental pathology, biochemistry, neurochemistry, enzymology, chronobiology, receptor studies, endocrinology, immunology and neuroimmunology, animal physiology, animal breeding and ethology, human ethology, psychology and others) and from clinical research (neurology, psychiatry and child psychiatry, obstetrics and gynecology, pediatrics, endocrinology, immunology, cardiovascular studies, internal medicine, oncology and others) will be considered. The Journal publishes Original papers and Review Articles. Brief reports, Special Communications, proved they are based on adequate experimental evidence, Clinical Studies, Case Reports, Commentaries, Discussions, Letters to the Editor (correspondence column), Book Reviews, Congress Reports and other categories of articles (philosophy, art, social issues, medical and health policies, biomedical history, etc.) will be taken under consideration.