Ç×GQ1b Ç×ü ¾ç¼ºÀÎ ±Þ¼º ´«±ÙÀ°¸¶ºñÀÇ ÀÓ»ó¾ç»ó
Clinical Features of Acute Opthalmoplegia Associated with Anti-GQ1b Antibody
ÇѼ±Çù, ¿À¼¼¿, ¹Ú°æ¾Æ,
¼Ò¼Ó »ó¼¼Á¤º¸
ÇѼ±Çù ( Han Sun-Hyup )
¼º±Õ°ü´ëÇб³ ÀÇ°ú´ëÇÐ »ï¼º¼¿ïº´¿ø ¾È°úÇб³½Ç
¿À¼¼¿ ( Oh Sei-Yeul )
¼º±Õ°ü´ëÇб³ ÀÇ°ú´ëÇÐ »ï¼º¼¿ïº´¿ø ¾È°úÇб³½Ç
¹Ú°æ¾Æ ( Park Kyung-Ah )
¼º±Õ°ü´ëÇб³ ÀÇ°ú´ëÇÐ »ï¼º¼¿ïº´¿ø ¾È°úÇб³½Ç
Abstract
¸ñÀû: Ç×GQ1b Ç×ü ¾ç¼ºÀÎ ±Þ¼º ´«±ÙÀ°¸¶ºñȯÀÚÀÇ ÀÓ»ó¾ç»ó¿¡ ´ëÇؼ ¾Ë¾Æº¸°íÀÚ ÇÏ¿´´Ù.
´ë»ó°ú ¹æ¹ý: 2011³â 1¿ùºÎÅÍ 2018³â 7¿ù±îÁö ±Þ¼º º¹½Ã¸¦ ÁÖ¼Ò·Î ±¹³» »ó±Þ Á¾ÇÕº´¿ø¿¡ ³»¿øÇÑ È¯ÀÚ Áß Ç×GQ1b Ç×ü ¾ç¼ºÀÎ ´«±ÙÀ°¸¶ºñ ȯÀÚ 33¸íÀÇ Àǹ«±â·ÏÀ» ÈÄÇâÀûÀ¸·Î Á¶»çÇÏ¿´´Ù. ȯÀÚµéÀÇ ÀÓ»ó¾ç»ó, Ç×GQ1b Ç×ü°Ë»ç °á°ú ¹× Ä¡·á °á°ú¸¦ ºñ±³ ºÐ¼®ÇÏ¿´´Ù.
°á°ú: 33¸í Áß 8¸í(24%)¿¡¼ ÀüÇüÀûÀÎ ´«±ÙÀ°¸¶ºñ, ¿îµ¿½ÇÁ¶, °Ç¹Ý»ç¼Ò½ÇÀÇ ¼¼ Áõ»óÀ» ¸ðµÎ º¸¿´´Ù. ¿îµ¿½ÇÁ¶ ¾øÀÌ ´«±ÙÀ°¸¶ºñ¿Í °Ç¹Ý»ç¼Ò½Ç ¹× ÀεÎ-¸ñ-À§ÆÈ À§¾àÀ» º¸ÀÎ °æ¿ì°¡ 1¸í(3%) ÀÖ¾úÀ¸¸ç, ¿îµ¿½ÇÁ¶³ª °Ç¹Ý»ç¼Ò½Ç ¾øÀÌ ´«±ÙÀ°¸¶ºñ¿Í ÀεÎ-¸ñ-À§ÆÈ À§¾àÀ» º¸ÀÎ °æ¿ì°¡ 2¸í(6%)ÀÌ ÀÖ¾ú´Ù. ´Ù¸¥ ½Å°æÇÐÀû Áõ»ó ¾øÀÌ ±Þ¼º ´«±ÙÀ°¸¶ºñ¸¸ º¸ÀΠȯÀÚ°¡ 22¸í(67%)ÀÌ ÀÖ¾ú´Ù. 33¸íÀÇ È¯ÀÚ Áß 16¸í(48.5%)¿¡¼ ´ëÁõ Ä¡·á¸¸ ÇÏ¸ç °æ°ú °üÂûÇÏ¿´°í, 17¸í(51.5%)¿¡¼ Ãʱ⠸鿪¾ïÁ¦Ä¡·á¸¦ ½ÃÇàÇÏ¿´´Ù. 24¸í(72.7%)¿¡¼ Áõ»ó È£ÀüÀÌ ÀÖ¾ú°í 9¸í(27.3%)¿¡¼ »ç½Ã ¹× º¹½Ã Áõ»óÀÌ Áö¼ÓµÇ¾ú´Ù. ¹ßº´ ÈÄ ¿ÏÀü È£Àü±îÁö °É¸° ±â°£Àº Æò±Õ 2.52 ¡¾ 2.11°³¿ùÀ̾ú´Ù.
°á·Ð: Ç×GQ1b Ç×ü ¾ç¼º ±Þ¼º ´«±ÙÀ°¸¶ºñÀÇ ÀÓ»ó¾ç»óÀº Å»¼öÃʼº ½Å°æº´ÁõÀÇ ´Ù¾çÇÑ Áõ»óÀÌ ÁßøµÈ ÇüÅ·Π³ªÅ¸³¯ ¼ö ÀÖÀ¸¸ç, À̸¦ ÀÎÁöÇÏ´Â °ÍÀÌ ±Þ¼º ´«±ÙÀ°¸¶ºñ ȯÀÚÀÇ °¨º°¿¡ µµ¿òÀ» ÁÙ ¼ö ÀÖ´Ù.
Purpose: To investigate the clinical features of acute ophthalmoplegia associated with anti-GQ1b antibody in the Republic of Korea.
Methods: From January 2011 to July 2018, we retrospectively reviewed the medical records of all patients who tested positive for anti-GQ1b antibody, and who had been concurrently diagnosed with acute ophthalmoplegia at a tertiary hospital in the Republic of Korea. Ophthalmic and neurological features were carefully reviewed. Laboratory results including ganglioside antibody panels and treatment outcomes were analyzed.
Results: Thirty-three patients were enrolled in the study and 8 (24%) of them showed pure Miller-Fisher syndrome with all three cardinal symptoms of ophthalmoplegia, ataxia, and areflexia. One patient (3%) showed ophthalmoplegia, areflexia, and pharyngeal- cervical-brachial weakness without ataxia and 2 patients (6%) showed only ophthalmoplegia and pharyngeal-cervical- brachial weakness without ataxia and areflexia. Twenty-two patients (67%) showed only ophthalmoplegia without any other neurological symptom. Early immunosuppressant treatment was used to treat 17 patients, and observation only was conducted as the initial treatment for 16 patients (48.5%). Twenty-four patients (72.7%) showed improvement and 9 patients showed persistent strabismus and diplopia. The average duration until recovery was 2.52 ¡¾ 2.11 months.
Conclusions: The symptoms of acute ophthalmoplegia associated with anti-GQ1b antibody can manifest in various forms that overlap with clinical features of demyelinating neuropathy, so it is important to recognize such characteristics when treating acute ophthamoplegia.
Å°¿öµå
Acute ophthalmoplegia; Anti-GQ1b antibody; Areflexia; Ataxia; Atypical Miller-Fisher syndrome
¿ø¹® ¹× ¸µÅ©¾Æ¿ô Á¤º¸
µîÀçÀú³Î Á¤º¸