|
1
|
Du Y, Wang W, Zhang L, Li Y, Chen X, Yang H, Ding X. Case report on anti-GQ1b antibody syndrome: initial symptoms of pupil palsy and periorbital pain. Front Immunol 2024; 15:1474354. [PMID: 39742267 PMCID: PMC11685045 DOI: 10.3389/fimmu.2024.1474354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Accepted: 11/26/2024] [Indexed: 01/03/2025] Open
Abstract
Anti-GQ1b antibody syndrome is a spectrum of autoimmune disorders affecting nervous systems. We report a case of a 53-year-old woman presenting mydriasis with acute onset of periorbital pain, photophobia, and subsequently, diplopia. Despite weakly positive anti-GQ1b IgG antibody, the patient exhibited atypical features with isolated ophthalmoplegia and absence of classic Miller-Fisher syndrome triad. Symptoms improved spontaneously without specific immunotherapy. This case highlights the variable clinical presentations of anti-GQ1b antibody syndrome, emphasizing the importance of considering this diagnosis in patients with unexplained iris abnormalities and ophthalmoplegia.
Collapse
Affiliation(s)
- Yang Du
- Department of Neurology, Chengdu Second People's Hospital, Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Weidong Wang
- Department of Neurology, Chengdu Second People's Hospital, Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
- School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, China
| | - Lili Zhang
- Department of Neurology, Chengdu Second People's Hospital, Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Yuan Li
- Department of Neurology, Chengdu Second People's Hospital, Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
- School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, China
| | - Xiang Chen
- Department of Neurology, Chengdu Second People's Hospital, Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
- School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, China
| | - Hui Yang
- Department of Neurology, First AffiIiated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Xin Ding
- Department of Neurology, Chengdu Second People's Hospital, Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| |
Collapse
|
|
2
|
Spyromitrou-Xioufi P, Ntoulios G, Ladomenou F, Niotakis G, Tritou I, Vlachaki G. Miller Fisher Syndrome Triggered by Infections: A Review of the Literature and a Case Report. J Child Neurol 2021; 36:785-794. [PMID: 34448412 DOI: 10.1177/0883073820988428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM We reported a case of Miller Fisher syndrome following a breakthrough varicella zoster virus infection in an otherwise healthy 6-year-old male. The objective of this review was to summarize the infectious etiologic agents known to trigger Miller Fisher syndrome. METHODS Review of the literature on infections associated with Miller Fisher syndrome. RESULTS We identified 762 studies after duplicates were removed. Titles, abstracts, and full texts were screened. Finally, 37 studies were included in qualitative synthesis after citations and reference list were checked. The age range of cases reported was 0-78 years, and male sex was predominant in studies where these parameters were reported. The most common causative agent was Campylobacter jejuni followed by Haemophilus influenzae. CONCLUSIONS Our review highlights the importance of recognizing the infections triggering Miller Fisher syndrome. We also present a unique case of Miller Fisher syndrome associated with breakthrough varicella zoster virus infection. Preventive policies may consider population immunization for certain causative agents.
Collapse
Affiliation(s)
| | - Georgios Ntoulios
- Department of Pediatrics, 37793Venizeleion General Hospital, Crete, Greece
| | - Fani Ladomenou
- Department of Pediatrics, 37793Venizeleion General Hospital, Crete, Greece
| | - Georgios Niotakis
- Pediatric Neurology Clinic, 37793Venizeleion General Hospital, Crete, Greece
| | - Ioanna Tritou
- Department of Radiology, 97793Venizeleion General Hospital, Crete, Greece
| | - Georgia Vlachaki
- Department of Pediatrics, 37793Venizeleion General Hospital, Crete, Greece
| |
Collapse
|
|
3
|
Cai L, Hu Z, Liao J, Hong S, Kong L, Chen L, Luo Y, Li T, Jiang L. Clinical Characterization of Anti-GQ1b Antibody Syndrome in Childhood. Front Pediatr 2021; 9:649053. [PMID: 33996691 PMCID: PMC8116501 DOI: 10.3389/fped.2021.649053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 04/06/2021] [Indexed: 02/05/2023] Open
Abstract
Objective: To delineate the comprehensive clinical features of anti-GQ1b antibody syndrome in childhood. Methods: The clinical data of children diagnosed with anti-GQ1b antibody syndrome at two Chinese tertiary pediatric neurology centers were collected and analyzed. We also conducted a systematic literature review on anti-GQ1b antibody syndrome in children. Results: This study included 78 children with anti-GQ1b antibody syndrome, consisting of 12 previously unreported cases from the two Chinese centers. The median onset age was 10 years (range, 2-18 years). The most common phenotype was acute ophthalmoparesis (32%), followed by classic Miller Fisher syndrome (15%), and Bickerstaff brainstem encephalitis (12%). External ophthalmoplegia (48%), sensory disturbance (9%), and bulbar palsy (9%) were the three most frequent onset symptom manifestations. Brain or spinal lesions on MRI and abnormal recordings by nerve conduction study were present in 18% (12/68) and 60% (27/45) of cases, respectively. There was CSF albuminocytologic dissociation in 34% of the patients (23/68). IV immunoglobulin alone or combined with steroids or plasma exchange was administered to 58% of patients (42/72). We did not find a significant correlation between early improvement up to 3 months and age onset and phenotype. All patients showed different degrees of recovery, and 81% (57/70) had complete recovery within 1 year. Conclusions: Acute ophthalmoparesis and classic Miller Fisher syndrome are the most common phenotypes of anti-GQ1b antibody syndrome in childhood. The majority of patients show good response to immunotherapy and have favorable prognosis.
Collapse
Affiliation(s)
- Lianhong Cai
- Department of Neurology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Zhanqi Hu
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Jianxiang Liao
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Siqi Hong
- Department of Neurology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Lingyu Kong
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Li Chen
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Yetao Luo
- Department of and Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Tingsong Li
- Department of Neurology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Li Jiang
- Department of Neurology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| |
Collapse
|
|
4
|
Spyromitrou-Xioufi P, Ntoulios G, Ladomenou F, Niotakis G, Tritou I, Vlachaki G. Miller Fisher Syndrome Triggered by Infections: A Review of the Literature and a Case Report. J Child Neurol 2021:883073821988428. [PMID: 33570020 DOI: 10.1177/0883073821988428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM We reported a case of Miller Fisher syndrome following a breakthrough varicella zoster virus infection in an otherwise healthy 6-year-old male. The objective of this review was to summarize the infectious etiologic agents known to trigger Miller Fisher syndrome. METHODS Review of the literature on infections associated with Miller Fisher syndrome. RESULTS We identified 762 studies after duplicates were removed. Titles, abstracts, and full texts were screened. Finally, 37 studies were included in qualitative synthesis after citations and reference list were checked. The age range of cases reported was 0-78 years, and male sex was predominant in studies where these parameters were reported. The most common causative agent was Campylobacter jejuni followed by Haemophilus influenzae. CONCLUSIONS Our review highlights the importance of recognizing the infections triggering Miller Fisher syndrome. We also present a unique case of Miller Fisher syndrome associated with breakthrough varicella zoster virus infection. Preventive policies may consider population immunization for certain causative agents.
Collapse
Affiliation(s)
| | - Georgios Ntoulios
- Department of Pediatrics, Venizeleion General Hospital, Crete, Greece
| | - Fani Ladomenou
- Department of Pediatrics, Venizeleion General Hospital, Crete, Greece
| | - Georgios Niotakis
- Pediatric Neurology Clinic, Venizeleion General Hospital, Crete, Greece
| | - Ioanna Tritou
- Department of Radiology, Venizeleion General Hospital, Crete, Greece
| | - Georgia Vlachaki
- Department of Pediatrics, Venizeleion General Hospital, Crete, Greece
| |
Collapse
|