Stiff-Man Syndrome and Variants

Stiff-Man Syndrome and Variants
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DOI:
10.1001/archneurol.2011.991
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发表时间:
2012-02-01
影响因子:
--
通讯作者:
Pittock, Sean J.
Pittock, Sean J.
中科院分区:
其他
文献类型:
--
作者:
McKeon, Andrew;Robinson, Maisha T.;Pittock, Sean J.

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背景:关于僵硬人综合征(SMS)(经典形式或其变体)的发病率或长期治疗反应和结果的信息很少。目的:综合描述一组SMS患者的特征。设计:观察性研究。地点:明尼苏达州罗切斯特市梅奥诊所。患者:99例经典SMS与疾病变体患者,谷氨酸脱羧酶65kd异构体(GAD65)抗体血清阳性和血清阴性。主要结局指标:神经学、自身免疫、血清学和肿瘤学结果;治疗;以及1984年1月至2008年12月的结果。结果:中位随访时间为5年(范围0-23年)。79例患者(典型SMS 59例,部分SMS 19例,进行性脑脊髓炎伴强直和肌阵挛[PERM] 1例)GAD65抗体血清阳性。其中67%(79人中的53人)患有至少一种共存的自身免疫性疾病,4%(79人中的3人)患有癌症。典型SMS患者初始评估时的GAD65抗体值(中值为623 nmol/L)显著高于部分SMS患者(中值为163 nmol/L) (P
Background: Little information is available about the incidence of stiff-man syndrome (SMS) (the classic form or its variants) or about long-term treatment responses and outcomes.Objective: To comprehensively describe the characteristics of a cohort of patients with SMS.Design: Observational study.Setting: Mayo Clinic, Rochester, Minnesota.Patients: Ninety-nine patients with classic SMS vs variants of the disorder, both glutamic acid decarboxylase 65 kD isoform (GAD65) antibody seropositive and seronegative.Main Outcome Measures: Neurological, autoimmune, serological, and oncological findings; treatments; and outcomes between January 1984 and December 2008.Results: The median follow-up duration was 5 years (range, 0-23 years). Seventy-nine patients (59 having classic SMS, 19 having partial SMS, and 1 having progressive encephalomyelitis with rigidity and myoclonus [PERM]) were GAD65 antibody seropositive. Sixty-seven percent (53 of 79) of them had at least 1 coexisting autoimmune disease, and 4% (3 of 79) had cancer. GAD65 antibody values at initial evaluation were significantly higher among patients with classic SMS (median value, 623 nmol/L) than among patients with partial SMS (median value, 163 nmol/L) (P