SARS-CoV-2感染后出现抗nf186抗体的自身免疫性结节病1例报告

IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY
Junmei Lai, Xiaofeng Zhang, Yiqi Wang, Yifan Cheng, Haochu Wang, Wei Zhu
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引用次数: 0

摘要

背景:自身免疫性结节病是一种独特的实体,其特征是抗体靶向淋巴结/副淋巴结蛋白,如神经束蛋白186 (NF186),导致传导缺陷和神经功能障碍。本报告强调了SARS-CoV-2感染后具有抗nf186抗体的自身免疫性结节病的独特病例。病例介绍:47岁女性,确诊10天后出现急性肢体麻木无力,发展为呼吸肌麻痹,需机械通气。最初静脉注射免疫球蛋白和类固醇治疗无效。通过临床检查、肌电图(EMG)和基于细胞的血清抗体检测,确诊自身免疫性结节病的抗nf186抗体。患者经血浆交换治疗部分改善,经利妥昔单抗治疗后病情稳定,符合抗nf186自身免疫性结节病的典型治疗反应模式。值得注意的是,再次感染SARS-CoV-2并没有加重她的症状,随着时间的推移,观察到肌肉力量逐渐恢复,到2023年11月,患者在日常活动中恢复了很大的独立性。结论:该病例是首次报道的SARS-CoV-2感染后出现抗nf186自身免疫性结节病的病例,强调了病毒触发因素与自身免疫性神经系统疾病之间的潜在联系。它强调了在covid - 19后神经症状中检测特异性淋巴结/副淋巴结抗体的重要性,并强调了血浆交换和b细胞消耗疗法在治疗结节病方面优于常规疗法的疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Autoimmune nodopathy with anti-NF186 antibodies following SARS-CoV-2 infection: a case report.

Background: Autoimmune nodopathy is a distinct entity characterized by antibodies targeting nodal/paranodal proteins like neurofascin-186 (NF186), leading to conduction defects and neurological dysfunction. This report highlights a unique case of autoimmune nodopathy with anti-NF186 antibodies following SARS-CoV-2 infection.

Case presentation: A 47-year-old female developed acute limb numbness and weakness ten days post-COVID-19 diagnosis, which progressed to respiratory muscle paralysis necessitating mechanical ventilation. Initial treatments with intravenous immunoglobulin and steroids were ineffective. Diagnosis of autoimmune nodopathy with anti-NF186 antibodies was confirmed through clinical examination, electromyography (EMG), and serum antibody testing using cell-based assays. The patient showed partial improvement with plasma exchange therapy and achieved stability after rituximab treatment, consistent with the typical treatment response pattern for anti-NF186 autoimmune nodopathy. Notably, re-infection with SARS-CoV-2 did not exacerbate her symptoms, and a gradual recovery of muscle strength was observed over time, with the patient regaining substantial independence in daily activities by November 2023.

Conclusions: This case represents the first reported occurrence of anti-NF186 autoimmune nodopathy following SARS-CoV-2 infection, underscoring the potential link between viral triggers and autoimmune neurological disorders. It emphasizes the importance of testing for specific nodal/paranodal antibodies in post-COVID neurological presentations and highlights the superior efficacy of plasma exchange and B-cell depleting therapies over conventional treatments in managing nodopathies.

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来源期刊
BMC Neurology
BMC Neurology 医学-临床神经学
CiteScore
4.20
自引率
0.00%
发文量
428
审稿时长
3-8 weeks
期刊介绍: BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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