Subject(s)
Pressure Ulcer/nursing , Pressure Ulcer/prevention & control , Benchmarking/standards , Cross-Sectional Studies , Expert Testimony/legislation & jurisprudence , Germany , Humans , Malpractice/legislation & jurisprudence , Nursing Records/standards , Patient Positioning/nursing , Pressure Ulcer/classification , Pressure Ulcer/etiology , Quality Assurance, Health Care/legislation & jurisprudence , Quality Assurance, Health Care/standards , Risk FactorsABSTRACT
Guillain-Barré Syndrome (GBS) is the most frequent cause of neuromuscular paralysis in industrialized countries and usually occurs after respiratory and gastrointestinal infections. However, in rare cases GBS is associated with Graft-versus-Host Disease (GvHD). In the present case we report on a female allogeneic bone marrow transplanted patient who developed GBS as a leading manifestation of GvHD subsequent to discontinuation of her immunosuppressive medication with cyclosporine. In contrast to former case reports both IVIg and plasma exchange failed while resumption of immunosuppressive medication improved the condition of the patient clearly.
Subject(s)
Graft vs Host Disease/diagnosis , Guillain-Barre Syndrome/etiology , Bone Marrow Transplantation , Female , Graft vs Host Disease/complications , Graft vs Host Disease/drug therapy , Guillain-Barre Syndrome/drug therapy , Humans , Immunoglobulins, Intravenous/therapeutic use , Immunosuppressive Agents/therapeutic use , Middle Aged , Transplantation, Homologous , Treatment OutcomeABSTRACT
Paraneoplastic cerebellar degeneration (PCD) is a rare immune mediated phenomenon often associated with cancer of the ovarian. Hitherto, tumor dissection is the mainstay in therapy while immunomodulatory treatment regimes often fail. Here we report on an 86 year old female patient who developed a severe pancerebellar syndrome. Clinical course, onconeural (anti-Yo) antibodies and detection of ovarian cancer suggest the assumption of PCD as the most probable diagnosis. We initiated a high-dose course of corticosteroids followed by a single dose of cyclophosphamide (600 mg/day). Surprisingly patient's condition improved and stabilized within days subsequent to cyclophosphamide application. This case demonstrates the benefit of immunosuppressive therapy in an anti-Yo positive patient with severe PCD secondary to an ovarian cancer.
