The Successful Application of Plasmapheresis in the Treatment of a Patient with Opsoclonus and Autoantibodies to Glutamate Receptor δ2

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Author(s)

    • Nakamagoe Kiyotaka
    • Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Japan
    • Nohara Seitaro
    • Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Japan
    • Takahashi Yukitoshi
    • National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Japan
    • Takiguchi Mao
    • Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Japan
    • Kawakami Rio
    • Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Japan
    • Koganezawa Tadachika
    • Department of Physiology, Division of Biomedical Science, Faculty of Medicine, University of Tsukuba, Japan
    • Tamaoka Akira
    • Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Japan

Abstract

<p>Glutamate receptor δ2 (GluRδ2) is expressed in the neuronal postsynaptic densities at the junctions between the Purkinje cells and the parallel fibers. Recent reports have described patients with opsoclonus who possess anti-GluRδ2 antibodies. We report the case of a 53-year-old man with opsoclonus whose cerebrospinal fluid was positive for anti-GluRδ2 antibodies. Electronystagmography revealed abnormal sinusoidal eye movements, which were definitively identified as opsoclonus. The frequency and amplitude of saccadic oscillations diminished after plasmapheresis (PE). The patient's opsoclonus was altered after PE, suggesting that anti-GluRδ2 antibodies may act on the saccade generator in the brainstem via the cerebellum and that they may be involved in the onset of opsoclonus. </p>

Journal

  • Internal Medicine

    Internal Medicine 56(20), 2773-2778, 2017

    The Japanese Society of Internal Medicine

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