Progression of right internal carotid artery stenosis in ischemic stroke patient with autoimmune polyglandular syndrome: A case report

Yuka Kanazawa, Ryu Matsuo, Yoshihisa Fukushima, Kenji Fukuda, Masahiro Kamouchi, Takanari Kitazono

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

A 40-year-old man who presented with left hemiparesis was admitted to our hospital. He had tachycardia and a fever. He had a 25-year history of insulin therapy for diabetes mellitus. Brain magnetic resonance (MR) images showed fresh infarction in the right hemisphere, and carotid ultrasonography showed stenosis of the right internal carotid artery (ICA). We determined that atherothrombotic brain infarction had likely occurred. After admission, the right ICA became narrow and finally occluded. Computed tomography revealed the presence of a thrombus in the right ICA, and gadoliniumenhanced MRA showed vasculitis of the ICA. In laboratory tests, his thyroid hormones were elevated. He was diagnosed with hyperthyroidism. After treatment, the tachycardia and high fever were improved. Because of a positive antiglutamic acid decarboxylase antibody test result, he was diagnosed with insulin-dependent diabetes mellitus. We found that he had anti-phospholipid antibody syndrome because he was positive for anti-beta-glycoprotein I antibody. These findings suggested that his condition was autoimmune polyglandular syndrome type 3. He received prednisolone and warfarin. After 3 months, his neurological findings were improved; however, occlusion of the ICA remained. Autoimmunity was considered to be the cause of ICA occlusion. Ischemic stroke with autoimmune polyglandular syndrome is very rare and is associated with progressive carotid lesions in juvenile patients. It is necessary to diagnose and treat this condition as soon as possible.

Original languageEnglish
Pages (from-to)531-535
Number of pages5
JournalClinical Neurology
Volume53
Issue number7
DOIs
Publication statusPublished - Aug 14 2013

Fingerprint

Carotid Stenosis
Internal Carotid Artery
Stroke
Tachycardia
Fever
Autoimmune Polyendocrinopathies
Brain Infarction
Carboxy-Lyases
Antiphospholipid Syndrome
Antibodies
Paresis
Warfarin
Hyperthyroidism
Vasculitis
Prednisolone
Autoimmunity
Type 1 Diabetes Mellitus
Thyroid Hormones
Infarction
Ultrasonography

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Progression of right internal carotid artery stenosis in ischemic stroke patient with autoimmune polyglandular syndrome : A case report. / Kanazawa, Yuka; Matsuo, Ryu; Fukushima, Yoshihisa; Fukuda, Kenji; Kamouchi, Masahiro; Kitazono, Takanari.

In: Clinical Neurology, Vol. 53, No. 7, 14.08.2013, p. 531-535.

Research output: Contribution to journalArticle

@article{338ebd8bd1ba47ceb68d231eed193fc1,
title = "Progression of right internal carotid artery stenosis in ischemic stroke patient with autoimmune polyglandular syndrome: A case report",
abstract = "A 40-year-old man who presented with left hemiparesis was admitted to our hospital. He had tachycardia and a fever. He had a 25-year history of insulin therapy for diabetes mellitus. Brain magnetic resonance (MR) images showed fresh infarction in the right hemisphere, and carotid ultrasonography showed stenosis of the right internal carotid artery (ICA). We determined that atherothrombotic brain infarction had likely occurred. After admission, the right ICA became narrow and finally occluded. Computed tomography revealed the presence of a thrombus in the right ICA, and gadoliniumenhanced MRA showed vasculitis of the ICA. In laboratory tests, his thyroid hormones were elevated. He was diagnosed with hyperthyroidism. After treatment, the tachycardia and high fever were improved. Because of a positive antiglutamic acid decarboxylase antibody test result, he was diagnosed with insulin-dependent diabetes mellitus. We found that he had anti-phospholipid antibody syndrome because he was positive for anti-beta-glycoprotein I antibody. These findings suggested that his condition was autoimmune polyglandular syndrome type 3. He received prednisolone and warfarin. After 3 months, his neurological findings were improved; however, occlusion of the ICA remained. Autoimmunity was considered to be the cause of ICA occlusion. Ischemic stroke with autoimmune polyglandular syndrome is very rare and is associated with progressive carotid lesions in juvenile patients. It is necessary to diagnose and treat this condition as soon as possible.",
author = "Yuka Kanazawa and Ryu Matsuo and Yoshihisa Fukushima and Kenji Fukuda and Masahiro Kamouchi and Takanari Kitazono",
year = "2013",
month = "8",
day = "14",
doi = "10.5692/clinicalneurol.53.531",
language = "English",
volume = "53",
pages = "531--535",
journal = "Clinical Neurology",
issn = "0009-918X",
publisher = "Societas Neurologica Japonica",
number = "7",

}

TY - JOUR

T1 - Progression of right internal carotid artery stenosis in ischemic stroke patient with autoimmune polyglandular syndrome

T2 - A case report

AU - Kanazawa, Yuka

AU - Matsuo, Ryu

AU - Fukushima, Yoshihisa

AU - Fukuda, Kenji

AU - Kamouchi, Masahiro

AU - Kitazono, Takanari

PY - 2013/8/14

Y1 - 2013/8/14

N2 - A 40-year-old man who presented with left hemiparesis was admitted to our hospital. He had tachycardia and a fever. He had a 25-year history of insulin therapy for diabetes mellitus. Brain magnetic resonance (MR) images showed fresh infarction in the right hemisphere, and carotid ultrasonography showed stenosis of the right internal carotid artery (ICA). We determined that atherothrombotic brain infarction had likely occurred. After admission, the right ICA became narrow and finally occluded. Computed tomography revealed the presence of a thrombus in the right ICA, and gadoliniumenhanced MRA showed vasculitis of the ICA. In laboratory tests, his thyroid hormones were elevated. He was diagnosed with hyperthyroidism. After treatment, the tachycardia and high fever were improved. Because of a positive antiglutamic acid decarboxylase antibody test result, he was diagnosed with insulin-dependent diabetes mellitus. We found that he had anti-phospholipid antibody syndrome because he was positive for anti-beta-glycoprotein I antibody. These findings suggested that his condition was autoimmune polyglandular syndrome type 3. He received prednisolone and warfarin. After 3 months, his neurological findings were improved; however, occlusion of the ICA remained. Autoimmunity was considered to be the cause of ICA occlusion. Ischemic stroke with autoimmune polyglandular syndrome is very rare and is associated with progressive carotid lesions in juvenile patients. It is necessary to diagnose and treat this condition as soon as possible.

AB - A 40-year-old man who presented with left hemiparesis was admitted to our hospital. He had tachycardia and a fever. He had a 25-year history of insulin therapy for diabetes mellitus. Brain magnetic resonance (MR) images showed fresh infarction in the right hemisphere, and carotid ultrasonography showed stenosis of the right internal carotid artery (ICA). We determined that atherothrombotic brain infarction had likely occurred. After admission, the right ICA became narrow and finally occluded. Computed tomography revealed the presence of a thrombus in the right ICA, and gadoliniumenhanced MRA showed vasculitis of the ICA. In laboratory tests, his thyroid hormones were elevated. He was diagnosed with hyperthyroidism. After treatment, the tachycardia and high fever were improved. Because of a positive antiglutamic acid decarboxylase antibody test result, he was diagnosed with insulin-dependent diabetes mellitus. We found that he had anti-phospholipid antibody syndrome because he was positive for anti-beta-glycoprotein I antibody. These findings suggested that his condition was autoimmune polyglandular syndrome type 3. He received prednisolone and warfarin. After 3 months, his neurological findings were improved; however, occlusion of the ICA remained. Autoimmunity was considered to be the cause of ICA occlusion. Ischemic stroke with autoimmune polyglandular syndrome is very rare and is associated with progressive carotid lesions in juvenile patients. It is necessary to diagnose and treat this condition as soon as possible.

UR - http://www.scopus.com/inward/record.url?scp=84881276131&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84881276131&partnerID=8YFLogxK

U2 - 10.5692/clinicalneurol.53.531

DO - 10.5692/clinicalneurol.53.531

M3 - Article

AN - SCOPUS:84881276131

VL - 53

SP - 531

EP - 535

JO - Clinical Neurology

JF - Clinical Neurology

SN - 0009-918X

IS - 7

ER -