Intravenous immunoglobulin treatment in a patient with adrenomyeloneuropathy

Aia E. Jønch*, Else R. Danielsen, Carsten Thomsen, Per Meden, Kirsten Svenstrup, Jørgen E. Nielsen

*Corresponding author af dette arbejde

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    Abstrakt

    Background: Adrenomyeloneuropathy (AMN) is one of several phenotypes of the adrenoleukodystrophy spectrum caused by mutations in the ABCD1 gene on the X chromosome. An inflammatory component is part of the disease complex ranging from severe childhood CNS demyelination to spinal cord and peripheral nerve degeneration.Case presentation: We present a patient with clinical progressive AMN and severe lower limb pain. Longitudinal brain magnetic resonance spectroscopy showed a constant slightly elevated myoinositol/total creatine ratio during the five year treatment period, probably reflecting demyelination, microglial activation and gliosis, indicating an inflammatory response. The pain was refractory to conventional therapy but intravenous immunoglobulin (IVIG) treatment was highly efficient.Conclusion: IVIG may be considered as a last resort for treatment of refractory pain in AMN patients with indications of an inflammatory component.

    OriginalsprogEngelsk
    Artikelnummer108
    TidsskriftBMC Neurology
    Vol/bind12
    DOI
    StatusUdgivet - 26 sep. 2012

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