Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Guillain-Barré syndrome following cytomegalovirus infection with increased level of antibody against moesin-a case report

Yuji Shiga, M.D.1)4), Yutaka Shimoe, M.D., Ph.D.1), Masafumi Chigusa, M.D.2), Susumu Kusunoki, M.D., Ph.D.3), Masahiro Mori, M.D., Ph.D.2) and Masaru Kuriyama, M.D., Ph.D.1)

1)Department of Neurology, Brain Attack Center, Ota Memorial Hospital
2)Department of Neurology, Graduate School of Medicine, Chiba University
3)KINDAI University School of Medicine, Department of Neurology
4)Present address: Hiroshima University Graduate School of Biomedical and Health Sciences

A 28-year-old man noticed sensory disturbance in the distal parts of his four extremities and muscle weakness of his hands two weeks after cytomegalovirus (CMV) infection. He had splenomegaly, impairment of hepatic function and peripheral neuropathy with decreased tendon reflexes. Protein-cell dissociation was observed in the cerebrospinal fluid, and the nerve conduction study (NCS) showed the changes due to demyelination. Intravenous immunoglobulin therapy was performed for 5 days after the diagnosis of Guillain-Barré syndrome. He did not show any severe symptoms such as bulbar palsy and was discharged on day 16. Anti-GM2 and anti-GalNAc-GD1a IgM antibodies were detected and acute inflammatory demyelinating polyneuropathy following the CMV infection was confirmed. NCS showed the abnormal changes were normalized after 4 months. The levels of antibodies against moesin, which is a protein existing in trace amounts in node of Ranvier, were increased. However, the antibodies were not detected 4 months after therapy. These changes were well correlated to his clinical course.
Full Text of this Article in Japanese PDF (639K)

(CLINICA NEUROL, 58: 385|389, 2018)
key words: Guillain-Barré syndrome, cytomegalovirus infection, anti-moesin antibody, anti-GM2 IgM antibody, acute inflammatory demyelinating polyneuropathy

(Received: 29-Jan-18)