A Case of Miller-Fisher Syndrome with Syndrome of Inappropriate Secretion of Antidiuretic Hormone

Shunya Fujiwara, Yasuhiro Manabe, Yumiko Nakano, Yoshio Omote, Hisashi Narai, Koji Abe

Research output: Contribution to journalArticlepeer-review

Abstract

We report a 72-year-old woman with Miller-Fisher syndrome (MFS) with syndrome of inappropriate secretion of antidiuretic hormone (SIADH). She developed diplopia and unsteady gait a week after an upper respiratory infection. Neurologic examination revealed ophthalmoplegia, ataxia, symmetrical weakness, numbness, and areflexia. She underwent intravenous immunoglobulin therapy. Her serum sodium concentration decreased to 119 mEq/L on day 12. She had low plasma osmolarity (254 mosm/kg), high urine osmolarity (457 mosm/kg), and high urine sodium level (73 mEq/L), while the blood level of antidiuretic hormone was normal. Anti-GD1b immunoglobulin G (IgG),-GQ1b IgG,-GT1a IgG, and-Gal-C IgM antibodies were positive. We diagnosed her with MFS overlapping with SIADH. Four weeks after onset, her symptoms recovered. The elevation of anti-GD1b,-GQ1b, and-GT1a antibodies that recognize disialosyl residue may be pathologically related to SIADH.

Original languageEnglish
Pages (from-to)380-383
Number of pages4
JournalCase Reports in Neurology
Volume13
Issue number2
DOIs
Publication statusPublished - Jun 14 2021
Externally publishedYes

Keywords

  • Hyponatremia
  • Miller-Fisher syndrome
  • Syndrome of inappropriate secretion of antidiuretic hormone

ASJC Scopus subject areas

  • Clinical Neurology

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