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 language | English |
|---|---|
| Pages (from-to) | 531-535 |
| Number of pages | 5 |
| Journal | Clinical Neurology |
| Volume | 53 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Aug 14 2013 |
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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 journal › Article
}
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 -