Intractable hiccup and nausea in neuromyelitis optica with anti-aquaporin-4 antibody: a herald of acute exacerbations
Intractable hiccup and nausea in neuromyelitis optica with anti-aquaporin-4 antibody: a herald of acute exacerbations
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DOI：
10.1136/jnnp.2008.145391
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发表时间：
2008-09-01
影响因子：
11
通讯作者：
Itoyama, Y.
中科院分区：
文献类型：
--
作者：
Takahashi, T.;Miyazawa, I.;Itoyama, Y.
背景：顽固性呃逆和恶心（IHN）是视神经肌病（NMO）的独特症状。近年来的研究表明，NMO的发病机制与抗水通道蛋白4（AQP4）抗体密切相关。方法：回顾性分析35例抗AQP4抗体阳性的IHN患者的临床资料。结果：35例NMO患者中有15例（43%）发生了IHN。这15例患者共发生35次IHN，其中23次（66%）发生打嗝，28次（80%）发生恶心。IHN常先于（54%）或伴发（29%）肌炎或视神经炎。IHN通常在病毒感染发作之前发生。结论：IHN可作为顽固性呃逆发作早期的临床指标。当在NMO患者中观察到INH时，可能需要仔细观察，并且早期开始治疗可以防止随后的神经损伤。
Background: Intractable hiccup and nausea (IHN) are unique symptoms in neuromyelitis optica (NMO). Recent studies have strongly suggested that the pathogenesis of NMO is closely associated with anti-aquaporin-4 (AQP4) antibody. However, clinical implications of IHN and the relationship with anti-AQP4 antibody remain unknown.Methods: The past medical records of 35 patients with seropositivity for anti-AQP4 antibody were reviewed. We also followed the titres of anti-AQP4 antibody in a patient with NMO, who had newly developed IHN.Results: Of the 35 patients, 15 patients (43%) had episodes of IHN. There was a total of 35 episodes of IHN in these 15 patients and, of the 35 episodes, hiccup was seen in 23 episodes (66%) and nausea was seen in 28 episodes (80%). The IHN frequently preceded (54%) or accompanied (29%) myelitis or optic neuritis. The IHN was often preceded by an episode of viral infection. The titres of anti-AQP4 antibody were remarkably increased when the intractable hiccup appeared in a case.Conclusions: IHN could be a clinical marker for the early phase of an exacerbation. Careful observation may be needed when INH is seen in patients with NMO, and the early initiation of the treatment could prevent subsequent neurological damage.