FDG-PETが診断に有用であった抗 amphiphysin 抗体陽性 stiff-person 症候群の1例 A case of antiamphiphysin antibody-positive stiff-person syndrome with breast cancer diagnosed by FDG-PET

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症例は46歳の女性である.約1カ月の経過で両下肢に筋硬直,有痛性筋痙攣が出現し,尖足位となった.抗GAD抗体は陰性で,抗amphiphysin抗体61,440倍と高値であり,傍腫瘍性症候群によるstiff-person症候群と診断した.悪性腫瘍の検索のためマンモグラフィーなどを施行したが,腫瘍病変はみとめられなかった.FDG-PETにて左腋窩部リンパ節に集積がみとめられ,同部のリンパ節郭清術を施行し,病理検査により乳癌と診断された.ステロイド治療により筋硬直,有痛性筋痙攣は消失した.抗amphiphysin抗体陽性stiff-person症候群では悪性腫瘍の早期検出にFDG-PETが有用と考えられた.<br>

We report a case of antiamphiphysin antiboddy-positive stiff-person syndrome associated with breast cancer, which was detected only by FDG-PET. A 46-year-old woman was admitted to our hospital because of painful muscle cramp and stiffness of both legs. Laboratory results were negative for anti-GAD antibody, but highly positive for antiamphiphysin antibody (1: 61,440). She had been diagnosed as having paraneoplastic stiff-person syndrome. However, mammogram, thoracic CT, breast MRI and ultrasonic echography showed no abnormal findings. A whole-body fluorodeoxyglucose (FDG) PET was performed, showing an increased uptake in the left axillary lymph nodes. Then, the left axillary lymph nodes were resected and immunohistochemically diagnosed as breast adenocarcinoma. Treatment of stiff-person syndrome was initiated with corticosteroids followed by chemotherapy against breast cancer, which led to a remarkable improvement of her neurological symptoms. If there is possibility of paraneoplastic syndromes like stiff-person syndrome, FDG-PET is very useful for detecting the occult carcinoma.<br>

収録刊行物

  • 臨床神経学 : CLINICAL NEUROLOGY  

    臨床神経学 : CLINICAL NEUROLOGY 48(6), 410-414, 2008-06-01 

    Societas Neurologica Japonica

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各種コード

  • NII論文ID(NAID)
    10021187761
  • NII書誌ID(NCID)
    AN00253207
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    0009918X
  • NDL 記事登録ID
    9553141
  • NDL 雑誌分類
    ZS31(科学技術--医学--精神神経科学)
  • NDL 請求記号
    Z19-298
  • データ提供元
    CJP書誌  NDL  J-STAGE 
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