伴低钠血症脑脊液抗Sufatide抗体阳性Guillain-Barré综合征的临床特点(附1例报告)

Clinical features of Guillain-Barrésyndrome with positive anti sulfatide antibody in CSF and hyponatremia(report of one case)

目的探讨伴低钠血症CSF抗Sufatide抗体阳性Guillain-Barré综合征(GBS)的临床特点及诊疗经验。方法回顾性分析1例伴低钠血症CSF抗Sufatide抗体阳性GBS的临床资料,并通过文献检索总结分析CSF抗Sufatide抗体阳性GBS患者的临床特点。结果文献检索收集2篇文献共2例CSF抗Sulfatide抗体阳性GBS患者的相关资料,结合本例病例共3例患者。患者均为男性,发病时间4~6 d。2例患者表现为四肢无力、剧烈腰背部及肢体疼痛,并出现CSF蛋白-细胞分离现象,使用人体免疫球蛋白治疗效果欠佳。并且本例患者使用人体免疫球蛋白后出现严重性低钠。1例患者表现为多脑神经损害,CSF蛋白轻度升高,使用人体免疫球蛋白后症状改善。结论以四肢无力为主要表现的CSF抗Sufatide抗体阳性GBS患者建议进行血浆置换,以防输注人体免疫球蛋白效果欠佳或导致顽固性低钠加重病情,进而影响预后。

Objective To summarize the diagnosis and treatment experience of patients with Guillain-Barrésyndrome(GBS)with positive anti sulfatide antibody in CSF.Methods The clinical data of a case of patient with GBS with positive anti sulfatide antibody in CSF in Department of Neurology,The Affiliated Brain Hospital of Nanjing Medical University in January,2023 were retrospectively analyzed,and the relevant literatures were reviewed.Results Two cases with GBS with positive anti sulfatide antibody in CSF from 2 literatures were retrieved,a total of 3 cases were retrieved.All cases were males.The onset duration was 4-6 d.Two patients with GBS with positive anti-sufatide antibody in CSF developed limb weakness,severe back and limb pain.Albuminocytologic dissociation in CSF and inefficacy of immunoglobin were found in the two cases.Severe hyponatremia secondary to intravenous immunoglobin was observed in our case.One patient presented with cranial nerve damage with mild elevation of CSF protein and improvement after immunoglobulin.Conclusion The plasmapheresis was recommended for the patients presenting with limb weakness with positive anti-sulfatide antibody in CSF in order to prevent inefficacy and severe hyponatremia secondary to intravenous immunoglobin.