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Cerimagic D, Bilic E. Reversible splenial lesion syndrome in patient with acute motor and sensory axonal neuropathy. Clin Neurol Neurosurg 2024; 237:108122. [PMID: 38262155 DOI: 10.1016/j.clineuro.2024.108122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 12/20/2023] [Accepted: 01/12/2024] [Indexed: 01/25/2024]
Abstract
Even though the classical clinical concept supports the clear difference between diseases affecting the central and peripheral nervous systems, this difference is becoming less rigid. Here, we report the case of a 50-year-old male patient who presented with acroparaesthesia, headache, and flaccid tetraparesis after febrile diarrhea. Nerve conduction studies indicated action potentials with low amplitudes, which are typical in acute motor and sensory axonal neuropathy. Magnetic resonance revealed a round lesion in the splenium consistent with a diagnosis of reversible splenial lesion syndrome. A polyclonal antiganglioside antibody response was detected. The patient was successfully treated with intravenous immunoglobulins. The coexistence of reversible splenial lesion syndrome and acute motor and sensory axonal neuropathy has not been described in the literature so far. We discuss our diagnostic dilemmas and the possible role of antiganglioside antibodies in the occurrence of simultaneous lesions of the central and peripheral nervous systems.
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Affiliation(s)
- Denis Cerimagic
- Department of Neurology, University of Dubrovnik and Polyclinic Glavic, Cira Carica 3, HR-20000 Dubrovnik, Croatia.
| | - Ervina Bilic
- Clinical Department of Neurology, University Hospital Center, School of Medicine, University of Zagreb, Kispaticeva 12, HR-10000 Zagreb, Croatia.
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Xu Y, Sun J, Yang L, Zhao S, Liu X, Su Y, Zhang J, Zhao M. Gangliosides play important roles in the nervous system by regulating ion concentrations. Neurochem Res 2022; 47:1791-1798. [PMID: 35426597 DOI: 10.1007/s11064-022-03576-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 12/30/2022]
Abstract
Gangliosides are important components of the neuronal cell membrane and play a vital role in the development of neurons and the brain. They participate in neurotransmission and are considered as the structural basis of learning and memory. Gangliosides participate in several and important physiological processes, such as cell differentiation, cell signaling, neuroprotection, nerve regeneration and apoptosis. The stability of ion concentration in excitable cells is particularly important in the maintenance of a steady state of cells and in the regulation of physiological functions. Ion concentration has been found to be related to the ganglioside's regulation in many neurological diseases, and several studies have found that they can stabilize intracellular ion concentration by regulating ion channels, which highlights their important regulatory role in neuronal excitability and synaptic transmission. Gangliosides can influence some forms of ion transport, by directly binding to ion transporters or through indirect binding and activation of transport proteins via appropriate signaling pathways. Therefore, the important and special role of gangliosides in the homeostasis of ion concentration is becoming a hot topic in the field and a theoretical basis in promoting help gangliosides use as key drugs for the treatment of nervous system diseases.
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Affiliation(s)
- Yijia Xu
- School of Life Sciences and Biopharmaceutical Science, Shenyang Pharmaceutical University, 110016, Shenyang, Liaoning, PR China
| | - Jianfang Sun
- School of Life Sciences and Biopharmaceutical Science, Shenyang Pharmaceutical University, 110016, Shenyang, Liaoning, PR China
| | - Liying Yang
- School of Life Sciences and Biopharmaceutical Science, Shenyang Pharmaceutical University, 110016, Shenyang, Liaoning, PR China
| | - Shangfeng Zhao
- School of Life Sciences and Biopharmaceutical Science, Shenyang Pharmaceutical University, 110016, Shenyang, Liaoning, PR China
| | - Xin Liu
- School of Life Sciences and Biopharmaceutical Science, Shenyang Pharmaceutical University, 110016, Shenyang, Liaoning, PR China
| | - Yang Su
- Department of General Surgery, Shengjing Hospital of China Medical University, 110004, Shenyang, PR China
| | - Jinghai Zhang
- School of Medical Devices, Shenyang Pharmaceutical University, 110016, Shenyang, PR China
| | - Mingyi Zhao
- School of Life Sciences and Biopharmaceutical Science, Shenyang Pharmaceutical University, 110016, Shenyang, Liaoning, PR China.
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Chen J, Ma JX, Zuo CH, Zhang Q, Chen HT, Ma XL. Severe Guillain-Barré syndrome after surgery for multiple fractures: a rare case report with a 5-year follow-up and a brief review of the literature. BMC Musculoskelet Disord 2021; 22:8. [PMID: 33397348 PMCID: PMC7781168 DOI: 10.1186/s12891-020-03864-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 12/08/2020] [Indexed: 12/02/2022] Open
Abstract
Background Guillain-Barré syndrome (GBS) is the most common and serious acute paralytic neuropathy and is usually caused by infection. It is thought to be the result of an aberrant response of the immune system. To our knowledge, GBS, especially severe GBS, after orthopaedic surgery has rarely been reported. Case presentation We herein report the case of a 58-year-old man who developed quadriplegia and respiratory failure on the 6th day after surgery for multiple fractures. The patient had no symptoms of respiratory or gastrointestinal tract infection within 4 weeks before the onset. The white blood cell count was normal, and there was no redness, swelling, heat or pain in the surgical incision. Brain, cervical and thoracic magnetic resonance imaging were normal, albuminocytological dissociation was found on cerebrospinal fluid examination, and electrophysiological examination showed that sensory and motor nerve evoked potentials could not be elicited. A diagnosis of post-traumatic GBS was made, and the patient was treated with intravenous immunoglobulin and plasma exchange, as well as supportive care and rehabilitation exercise. The length of stay was 18 months, and the in-hospital-related costs amounted to $127,171. At the last follow-up, the patient had recovered only grade 3 power in the upper limbs and grade 2 power in the lower limbs. Conclusions Severe GBS is a rare complication after orthopaedic surgery. When progressive weakness occurs in trauma patients, the possibility of GBS should be considered, and cerebrospinal fluid and electrophysiological examinations should be performed in a timely manner. For patients with severe GBS after trauma, the treatment costs may be high, and the prognosis may be poor.
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Affiliation(s)
- Jian Chen
- Department of Orthopaedics, People's Hospital of Xuancheng City, Xuancheng, China
| | - Jian-Xiong Ma
- Institute of Orthopedics, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Cai-Hong Zuo
- Department of Orthopaedics, People's Hospital of Xuancheng City, Xuancheng, China
| | - Qing Zhang
- Department of Orthopaedics, People's Hospital of Xuancheng City, Xuancheng, China
| | - Heng-Ting Chen
- Institute of Orthopedics, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Xin-Long Ma
- Institute of Orthopedics, Tianjin Hospital, Tianjin University, Tianjin, China.
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Antiganglioside antibodies in neurological diseases. J Neurol Sci 2020; 408:116576. [DOI: 10.1016/j.jns.2019.116576] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/13/2019] [Accepted: 11/06/2019] [Indexed: 12/14/2022]
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Intrathecal antibody responses to GalC in Guillain-Barré syndrome triggered by Mycoplasma pneumoniae. J Neuroimmunol 2018; 314:13-16. [DOI: 10.1016/j.jneuroim.2017.11.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/15/2017] [Accepted: 11/15/2017] [Indexed: 12/16/2022]
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Melo CFOR, Delafiori J, de Oliveira DN, Guerreiro TM, Esteves CZ, Lima EDO, Pando-Robles V, Catharino RR. Serum Metabolic Alterations upon Zika Infection. Front Microbiol 2017; 8:1954. [PMID: 29067015 PMCID: PMC5641361 DOI: 10.3389/fmicb.2017.01954] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 09/22/2017] [Indexed: 12/13/2022] Open
Abstract
Zika virus (ZIKV) infection has recently emerged as a major concern worldwide due to its strong association with nervous system malformation (microcephaly) of fetuses in pregnant women infected by the virus. Signs and symptoms of ZIKV infection are often mistaken with other common viral infections. Since transmission may occur through biological fluids exchange and coitus, in addition to mosquito bite, this condition is an important infectious disease. Thus, understanding the mechanism of viral infection has become an important research focus, as well as providing potential targets for assertive clinical diagnosis and quality screening for hemoderivatives. Within this context, the present work analyzed blood plasma from 79 subjects, divided as a control group and a ZIKV-infected group. Samples underwent direct-infusion mass spectrometry and statistical analysis, where eight markers related to the pathophysiological process of ZIKV infection were elected and characterized. Among these, Angiotensin (1-7) and Angiotensin I were upregulated under infection, showing an attempt to induce autophagy of the infected cells. However, this finding is concerning about hypertensive individuals under treatment with inhibitors of the Renin-Angiotensin System (RAS), which could reduce this response against the virus and exacerbate the symptoms of the infection. Moreover, one of the most abundant glycosphingolipids in the nervous tissue, Ganglioside GM2, was also elected in the present study as an infection biomarker. Considered an important pathogen receptor at membrane's outer layer, this finding represents the importance of gangliosides for ZIKV infection and its association with brain tropism. Furthermore, a series of phosphatidylinositols were also identified as biomarkers, implying a significant role of the PI3K-AKT-mTOR Pathway in this mechanism. Finally, these pathways may also be understood as potential targets to be considered in pharmacological intervention studies on ZIKV infection management.
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Affiliation(s)
- Carlos Fernando O R Melo
- INNOVARE Biomarkers Laboratory, School of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil
| | - Jeany Delafiori
- INNOVARE Biomarkers Laboratory, School of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil
| | - Diogo N de Oliveira
- INNOVARE Biomarkers Laboratory, School of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil
| | - Tatiane M Guerreiro
- INNOVARE Biomarkers Laboratory, School of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil
| | - Cibele Z Esteves
- INNOVARE Biomarkers Laboratory, School of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil
| | - Estela de O Lima
- INNOVARE Biomarkers Laboratory, School of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil
| | | | - Rodrigo R Catharino
- INNOVARE Biomarkers Laboratory, School of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil
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Wang L, Shao C, Yang C, Kang X, Zhang G. Association of anti-gangliosides antibodies and anti-CMV antibodies in Guillain-Barré syndrome. Brain Behav 2017; 7:e00690. [PMID: 28523231 PMCID: PMC5434194 DOI: 10.1002/brb3.690] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 02/10/2017] [Accepted: 02/28/2017] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Numerous types of infection were closely related to GBS, mainly including Campylobacter jejuni, Cytomegalovirus, which may lead to the production of anti-gangliosides antibodies (AGA). Currently, although there are increased studies on the AGA and a few studies of anti-CMV antibodies in GBS, the association between them remains poorly documented. Therefore, our research aims to analyze the correlation of anti-CMV antibodies and AGA in GBS. METHODS A total of 29 patients with GBS were enrolled in this study. The CMV antibodies were tested by the electrochemiluminescence immunoassay "ECLIA" (Roche Diagnostics GmbH). The serum gangliosides were determined by The EUROLINE test kit. RESULTS Of the 29 patients with GBS, 9 (31%) were AGA-seropositive, in which 22 were CMV-IgG positive in CSF at the same time, but all 29 samples were CMV-IgM negative in both serum and CSF. In the AGA-positive group, the rate of both serum and CSF positive was 87.5% (7/8), higher than 50% (7/14) of the negative group, although no statistical significance was found. In addition, we found that there was a trend of higher ratio of men, a younger age onset, less frequent preceding infection, a higher level of CSF proteins, and less frequent cranial nerve deficits, although the data did not reach a statistical significance. CONCLUSION In spite of no statistical significance association was found between serum AGA and CMV-IgG in serum and CSF. However, we found that there was a trend of high positive rate of both serum and CSF-CMV-IgG in AGA-positive than the negative group. So we should further expand the sample size to analyze the association between AGA and CMV or other neurotropic virus antibodies in various diseases, to observe whether they could be serological marker of these diseases (especially GBS) or the underlying pathogenesis.
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Affiliation(s)
- Lijuan Wang
- Department of Clinical Laboratory Beijing Tiantan Hospital Capital Medical University Beijing China
| | - Chunqing Shao
- Department of Clinical Laboratory Beijing Tiantan Hospital Capital Medical University Beijing China
| | - Chunjiao Yang
- Department of Clinical Laboratory Beijing Tiantan Hospital Capital Medical University Beijing China
| | - Xixiong Kang
- Department of Clinical Laboratory Beijing Tiantan Hospital Capital Medical University Beijing China.,China National Clinical Research Center for Neurological Diseases Beijing China.,Monogenic Disease Research Center for Neurological Disorder Beijing China
| | - Guojun Zhang
- Department of Clinical Laboratory Beijing Tiantan Hospital Capital Medical University Beijing China.,China National Clinical Research Center for Neurological Diseases Beijing China.,Monogenic Disease Research Center for Neurological Disorder Beijing China
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Langerak T, Yang H, Baptista M, Doornekamp L, Kerkman T, Codrington J, Roosblad J, Vreden SGS, De Bruin E, Mögling R, Jacobs BC, Pas SD, GeurtsvanKessel CH, Reusken CBEM, Koopmans MP, Van Gorp ECM, Alberga H. Zika Virus Infection and Guillain-Barré Syndrome in Three Patients from Suriname. Front Neurol 2016; 7:233. [PMID: 28066317 PMCID: PMC5177614 DOI: 10.3389/fneur.2016.00233] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 12/05/2016] [Indexed: 12/19/2022] Open
Abstract
We present three patients from Suriname who were diagnosed with Guillain–Barré syndrome (GBS) during the Zika virus (ZIKV) outbreak in this country. One patient had a positive ZIKV urine real-time RT-PCR (qRT-PCR) result. The other two patients had a negative ZIKV urine qRT-PCR but a positive virus neutralization test and presence of IgG antibodies against ZIKV in the serum. Considering the evidence of a past ZIKV infection and absence of evidence for recent infections with the most common preceding infections of GBS, it is very likely that these GBS cases were triggered by ZIKV.
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Affiliation(s)
- Thomas Langerak
- Department of Viroscience, Erasmus Medical Center , Rotterdam , Netherlands
| | - Harvey Yang
- Department of Neurology, Academic Hospital Paramaribo , Paramaribo , Suriname
| | - Mark Baptista
- Department of Neurology, St. Vincentius Hospital , Paramaribo , Suriname
| | - Laura Doornekamp
- Department of Viroscience, Erasmus Medical Center , Rotterdam , Netherlands
| | - Tessa Kerkman
- Department of Viroscience, Erasmus Medical Center , Rotterdam , Netherlands
| | - John Codrington
- Diagnostic Laboratory, Academic Hospital Paramaribo , Paramaribo , Suriname
| | - Jimmy Roosblad
- Diagnostic Laboratory, Academic Hospital Paramaribo , Paramaribo , Suriname
| | - Stephen G S Vreden
- Department of Internal Medicine, Academic Hospital Paramaribo , Paramaribo , Suriname
| | - Erwin De Bruin
- Department of Viroscience, Erasmus Medical Center , Rotterdam , Netherlands
| | - Ramona Mögling
- Department of Viroscience, Erasmus Medical Center , Rotterdam , Netherlands
| | - Bart C Jacobs
- Department of Neurology, Erasmus Medical Center, Rotterdam, Netherlands; Department of Immunology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Suzan D Pas
- Department of Viroscience, Erasmus Medical Center , Rotterdam , Netherlands
| | | | | | - Marion P Koopmans
- Department of Viroscience, Erasmus Medical Center , Rotterdam , Netherlands
| | - Eric C M Van Gorp
- Department of Viroscience, Erasmus Medical Center , Rotterdam , Netherlands
| | - Henk Alberga
- Department of Neurology, Academic Hospital Paramaribo , Paramaribo , Suriname
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