以视力下降为表现的抗GQ1b抗体综合征1例

A case of anti-GQ1b antibody syndrome characterized by decreased vision

本文报告1例以视力下降为表现的抗GQ1b抗体综合征。患者女,75岁,感冒后出现行走不稳、双眼视力下降。查体发现双侧瞳孔散大,对光反射迟钝,双眼视力下降、眼球固定,咽反射减弱,四肢手套、袜套样浅感觉减退,四肢腱反射减弱,闭目难立征阳性,直线行走不能完成。视觉诱发电位双眼P100潜伏期延长,肌电图提示双上肢周围神经损害,双下肢可疑周围神经损害。脑脊液蛋白细胞分离,血清抗GQ1b抗体IgG(+++),抗GT1a抗体IgG(+++)。给予静注人免疫球蛋白、静脉滴注及序贯口服激素治疗。3个月后视力完全恢复,行走不稳及四肢麻木完全缓解。抗GQ1b抗体综合征可出现视力下降,需准确送检抗体,早期诊断、治疗。

This paper reports a case of anti-GQ1b antibody syndrome presenting with vision deterioration.The patient,a 75-year-old female,developed unstable walking and decreased vision in both eyes after catching a cold.Physical examination showed that bilateral pupils were dilated,light reflex was dull,visual acuity decreased,eyeball fixed,pharynx reflex weakened,limb gloves and sock-like shallow sensation decreased,limb tendon reflex weakened,eye closure was difficult to stand positive,and straight line walking could not be completed.The latency of P100 was prolonged in both eyes of visual evoked potentials,and electromyography showed peripheral nerve damage in both upper limbs and suspected peripheral nerve damage in both lower limbs.Protein cells were isolated in cerebrospinal fluid.Serum anti-GQ1b antibody IgG(+)and anti-GT1a antibody IgG(+)were detected.Intravenous injection of human immunoglobulin,intravenous injection and sequential oral hormone therapy were given.After 3 months,the visual acuity was completely recovered,the walking instability and limb numbness were completely relieved.Anti-GQ1b antibody syndrome may have decreased vision,and it is necessary to accurately detect antibodies for early diagnosis and treatment.