DOI QR코드

DOI QR Code

Miller Fisher syndrome in a patient with pulmonary tuberculosis

  • Park, Jae Young (Department of Neurology, Veterans Health Service Medical Center) ;
  • Jung, Hoe Jong (Department of Neurology, Veterans Health Service Medical Center) ;
  • Bae, Heewon (Department of Neurology, Veterans Health Service Medical Center) ;
  • Han, Jeong-Ho (Department of Neurology, Veterans Health Service Medical Center) ;
  • Kang, Min Ju (Department of Neurology, Veterans Health Service Medical Center)
  • Received : 2020.07.30
  • Accepted : 2020.09.01
  • Published : 2020.10.31

Abstract

Miller Fisher syndrome (MFS) is characterized by the acute ophthalmoparesis, ataxia and areflexia. We describe the case of 70-year-old man with cardinal symptom of MFS and active pulmonary tuberculosis (Tb). A thorough evaluation led to the diagnosis of MFS and treatment with intravenous immunoglobulin (IVIg) was started. The complete resolution of ophthalmoparesis and ataxia was observed from the fourth day of IVIg treatment. This is the first report to describe a case of MFS that developed in patient pulmonary tuberculosis.

Keywords

References

  1. Yuki N, Hartung HP. Guillain-Barre syndrome. N Engl J Med 2012;366:2294-2304. https://doi.org/10.1056/NEJMra1114525
  2. Mohta S, Soneja M, Vyas S, Khot W. Tuberculosis and Guillain-Barre syndrome: a chance association? Intractable Rare Dis Res 2017;6:55-57. https://doi.org/10.5582/irdr.2016.01073
  3. Malakar S, Sharma TD, Raina S, Sharma KN, Kapoor D. Guillain Barre syndrome with pulmonary tuberculosis: a case series from a tertiary care hospital. J Family Med Prim Care 2019;8:1794-1797. https://doi.org/10.4103/jfmpc.jfmpc_161_19
  4. Garg RK. Tuberculosis of the central nervous system. Postgrad Med J 1999;75:133-140. https://doi.org/10.1136/pgmj.75.881.133
  5. Aranyi Z, Kovacs T, Sipos I, Bereczki D. Miller Fisher syndrome: brief overview and update with a focus on electrophysiological findings. Eur J Neurol 2012;19:15-20, e1-e3. https://doi.org/10.1111/j.1468-1331.2011.03445.x
  6. Yuki N. Infectious origins of, and molecular mimicry in, Guillain-Barre and Fisher syndromes. Lancet Infect Dis 2001;1:29-37. https://doi.org/10.1016/S1473-3099(01)00019-6
  7. Koga M, Gilbert M, Li J, Koike S, Takahashi M, Furukawa K, et al. Antecedent infections in Fisher syndrome: a common pathogenesis of molecular mimicry. Neurology 2005;64:1605-1611. https://doi.org/10.1212/01.WNL.0000160399.08456.7C
  8. Vyravanathan S, Senanayake N. Guillain-Barre syndrome associated with tuberculosis. Postgrad Med J 1983;59:516-517. https://doi.org/10.1136/pgmj.59.694.516
  9. Singh A, Balasubramanian V, Gupta N. The association of Guillain-Barre syndrome with pulmonary tuberculosis: chance or causal? Neurol India 2020;68:209-218. https://doi.org/10.4103/0028-3886.279657