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青年男性亚急性小脑性共济失调的罕见病因

敖冬慧 刘昕超 彭斌 朱以诚 崔丽英 姚明

敖冬慧, 刘昕超, 彭斌, 朱以诚, 崔丽英, 姚明. 青年男性亚急性小脑性共济失调的罕见病因[J]. 协和医学杂志, 2021, 12(1): 110-113. doi: 10.12290/xhyxzz.20180433
引用本文: 敖冬慧, 刘昕超, 彭斌, 朱以诚, 崔丽英, 姚明. 青年男性亚急性小脑性共济失调的罕见病因[J]. 协和医学杂志, 2021, 12(1): 110-113. doi: 10.12290/xhyxzz.20180433
AO Dong-hui, LIU Xin-chao, PENG Bin, ZHU Yi-cheng, CUI Li-ying, YAO Ming. A Rare Cause of Subacute Cerebellar Ataxia in a Young Man[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(1): 110-113. doi: 10.12290/xhyxzz.20180433
Citation: AO Dong-hui, LIU Xin-chao, PENG Bin, ZHU Yi-cheng, CUI Li-ying, YAO Ming. A Rare Cause of Subacute Cerebellar Ataxia in a Young Man[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(1): 110-113. doi: 10.12290/xhyxzz.20180433

青年男性亚急性小脑性共济失调的罕见病因

doi: 10.12290/xhyxzz.20180433
详细信息
    通讯作者:

    姚明 电话:010-69156372,E-mail: pumchym2011@yahoo.com

  • 中图分类号: R747.9; R373.9

A Rare Cause of Subacute Cerebellar Ataxia in a Young Man

More Information
  • 摘要: 亚急性小脑性共济失调多见于非典型感染、自身免疫性疾病和副肿瘤性小脑变性。本文报道1例表现为亚急性小脑性共济失调患者,其病因罕见。该患者男性,31岁,亚急性起病,临床表现为小脑性共济失调,严重免疫抑制状态,经筛查发现人类免疫缺陷病毒(human immunodeficiency virus, HIV)抗体及核酸均阳性、脑脊液JC病毒DNA阳性,临床诊断为JC病毒小脑颗粒细胞神经元病,经抗逆转录病毒治疗后共济失调症状好转, 3个月后随访症状稳定。JC病毒小脑颗粒细胞神经元病是一种JC病毒感染引起的新型临床症候,目前报道较少,本例为国内首次报道。本病例提示HIV感染免疫抑制患者出现共济失调时需筛查JC病毒,免疫功能的恢复有助于控制JC病毒小脑颗粒细胞神经元病症状进展。
    作者贡献:敖冬慧负责收集、分析临床资料,撰写本文;刘新超负责收集临床资料;彭斌、朱以诚、崔丽英负责审核;姚明负责分析临床资料,修改、校对。
    利益冲突  无
  • 图  1  头颅MRI T2WI(A)、T1WI(B)和T1增强矢状位(C)示小脑轻度萎缩

  • [1] Weber T, Trebst C, Frye S, et al. Analysis of the systemic and intrathecal humoral immune response in progressive multifocal leukoencephalopathy[J]. J Infect Dis, 1997, 176:250-254. doi:  10.1086/514032
    [2] Tan CS, Koralnik IJ. Progressive multifocal leukoencephalopathy and other disorders caused by JC virus: clinical features and pathogenesis[J]. Lancet Neurol, 2010, 9:425-437. doi:  10.1016/S1474-4422(10)70040-5
    [3] Astrom KE, Mancall EL, Richardson EPJ. Progressive multifocal leuko-encephalopathy; a hitherto unrecognized complication of chronic lymphatic leukaemia and Hodgkin's disease[J]. Brain, 1958, 81:93-111. doi:  10.1093/brain/81.1.93
    [4] 中华医学会感染病学分会艾滋病丙型肝炎学组, 中国疾病预防控制中心.中国艾滋病诊疗指南(2018版)[J].协和医学杂志, 2019, 10: 31-52.

    AIDS and Hepatitis C Professional Group, Society of Infectious Diseases, Chinese Medical Association; Chinese Cen-ter for Disease Control and Prevention. Chinese Guidelines for Diagnosis and Treatment of HIV/AIDS(2018)[J]. Xie He Yi Xue Za Zhi, 2019, 10: 31-52.
    [5] Tan K, Roda R, Ostrow L, et al. PML-IRIS in patients with HIV infection: clinical manifestations and treatment with steroids[J]. Neurology, 2009, 72:1458-1464. doi:  10.1212/01.wnl.0000343510.08643.74
    [6] du Pasquier RA, Koralnik IJ. Inflammatory reaction in progressive multifocal leukoencephalopathy: harmful or beneficial?[J]. J Neurovirol, 2003, 9:25-31. doi:  10.1080/13550280390195315
    [7] Koralnik IJ, Wüthrich C, Dang X, et al. JC virus granule cell neuronopathy: A novel clinical syndrome distinct from progressive multifocal leukoencephalopathy[J]. Ann Neurol, 2005, 57:576-580. doi:  10.1002/ana.20431
    [8] Reoma LB, Trindade CJ, Monaco MC, et al. Fatal encephalopathy with wild-type JC virus and ruxolitinib therapy[J]. Ann Neurol, 2019, 86:878-884. doi:  10.1002/ana.25608
    [9] Schippling S, Kempf C, Büchele F, et al. JC virus granule cell neuronopathy and GCN-IRIS under natalizumab treatment[J]. Ann Neurol, 2013, 74:622-626. doi:  10.1002/ana.23973
    [10] Gheuens S, Wüthrich C, Koralnik IJ. Progressive Multifocal Leukoencephalopathy: Why Gray and White Matter[J]. Annu Rev Pathol Mech Dis, 2013, 8:189-215. doi:  10.1146/annurev-pathol-020712-164018
    [11] du Pasquier RA, Corey S, Margolin DH, et al. Productive infection of cerebellar granule cell neurons by JC virus in an HIV+ individual[J]. Neurology, 2003, 61:775-782. doi:  10.1212/01.WNL.0000081306.86961.33
    [12] Wuthrich C, Cheng YM, Joseph JT, et al. Frequent infection of cerebellar granule cell neurons by polyomavirus JC in progressive multifocal leukoencephalopathy[J]. J Neuropathol Exp Neurol, 2009, 68:15-25. doi:  10.1097/NEN.0b013e3181912570
    [13] Dang X, Vidal JE, de Oliveira ACP, et al. JC virus granule cell neuronopathy is associated with VP1 C terminus mutants[J]. J Gen Virol, 2012, 93:175-183. doi:  10.1099/vir.0.037440-0
    [14] Agnihotri SP, Dang X, Carter JL, et al. JCV GCN in a natalizumab-treated MS patient is associated with mutations of the VP1 capsid gene[J]. Neurology, 2014, 83:727-732. doi:  10.1212/WNL.0000000000000713
    [15] Bartsch T, Rempe T, Leypoldt F, et al. The spectrum of progressive multifocal leukoencephalopathy: a practical approach[J]. Eur J Neurol, 2019, 26:566-e41. doi:  10.1111/ene.13906
    [16] Cinque P, Bossolasco S, Lundkvist A. Molecular analysis of cerebrospinal fluid in viral diseases of the central nervous system[J]. J Clin Virol, 2003, 26:1-28. doi:  10.1016/S1386-6532(02)00173-7
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出版历程
  • 收稿日期:  2018-10-30
  • 录用日期:  2019-06-10
  • 网络出版日期:  2020-06-26
  • 刊出日期:  2021-01-30

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