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Anti-GFAP neuroinflammation with synchronous bilateral papillitis and characteristic imaging
Practical Neurology Pub Date : 2021-04-01 , DOI: 10.1136/practneurol-2020-002805
William John Utley , Adam El-Dieb , Andrew Martin Chancellor

A 50-year-old female marine ecologist presented to the emergency department following 3 weeks of persistent headache, nausea, vomiting, disturbed vision, intermittent aural pulsations, unsteady gait and acroparesthesias. She had previously been healthy, specifically with no history of autoimmune disease. Mental status, vital signs and general medical examination were normal. Corrected visual acuity 6/60 right; 6/9 left. There were bilateral scotomata extending from the point of fixation towards the temporal field, worse on the right. She had a right afferent pupillary light defect. Funduscopy showed bilateral disc swelling with obscuration of vessels within the disc margins, without haemorrhage. Gait was slightly ataxic. There were no other abnormalities of the cranial nerves, motor or sensory examination. Haematology, chemistry and liver function tests were normal. Immunoglobulin (Ig)G 5.8 g/L (7.0–16.0) with IgA and IgM normal serum concentrations. Complement (C4) 0.18 g/L (0.2–0.6), with normal C3. Rheumatoid factor, anti-CCP IgG, antinuclear antibody, extractible nuclear antigen, anti-neutrophil cytoplasmic antibody (MPO+PR3), all normal. HIV and syphilis serology negative. Serum was negative for …

中文翻译:

同步性双侧乳头炎的抗GFAP神经炎症和特征性成像

一名50岁的女性海洋生态学家在持续出现头痛,恶心,呕吐,视力障碍,听觉间断性搏动,步态不稳和肢端感觉异常后三周就诊给急诊科。她以前很健康,特别是没有自身免疫性疾病的病史。精神状态,生命体征和一般体检均正常。矫正视力6/60对;还剩6/9。从固定点到颞侧有双侧骨,右侧更严重。她患有右传入瞳孔轻度缺损。眼底镜检查显示双侧椎间盘肿胀,椎间盘边缘内血管阻塞,无出血。步态有些共济失调。颅神经,运动或感觉检查无其他异常。血液学,化学和肝功能检查正常。免疫球蛋白(Ig)G 5.8 g / L(7.0-16.0),IgA和IgM正常血清浓度。补体(C4)0.18 g / L(0.2–0.6),标准C3。类风湿因子,抗CCP IgG,抗核抗体,可提取核抗原,抗中性粒细胞胞浆抗体(MPO + PR3)均正常。HIV和梅毒血清学阴性。血清对……不利。
更新日期:2021-03-16
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