Presentation of opsoclonus myoclonus ataxia syndrome with glutamic acid decarboxylase antibodies.

In this rare case, the patient presented with opsoclonus, myoclonus and ataxia. Serological and imaging studies revealed high glutamic acid decarboxylase antibody (GAD-Ab) levels. High-dose corticosteroids were of no benefit and subsequent intravenous immunoglobulin (IVIg) administration proved resolution of the condition. Levetiracetam proved useful in symptomatically controlling the myoclonus. Follow-up GAD-Ab levels were within normal limits.

Population differences in fever and sickness behaviors in a wild passerine: a role for cytokines.

Immune responses benefit hosts by clearing pathogens, but they also incur physiological costs and tissue damage. While wild animals differ in how they balance these costs and benefits, the physiological mechanisms underlying such differential investment in immunity remain unknown. Uncovering these mechanisms is crucial to determining how and where selection acts to shape immunological defense. Among free-living song sparrows (Melospiza melodia) in western North America, sickness-induced lethargy and fever are more pronounced in Southern California than in Washington and Alaska. We brought song sparrows from two populations (Southern California and Washington) into captivity to determine whether these differences persist in a common environment and what physiological signals facilitate such differences. As in free-living sparrows, captive California birds exhibited more pronounced fever and lethargy than Washington birds in response to lipopolysaccharide, a non-pathogenic antigen that mimics bacterial infection. After treatment, the two populations showed similar reductions in luteinizing hormone levels, food intake and body mass, although treated birds from California lost more breast muscle tissue than treated birds from Washington. Moreover, California birds displayed higher bioactivity of interleukin-6, a pro-inflammatory cytokine, and marginally higher levels of corticosterone, a steroid hormone involved in stress, metabolism and regulating inflammatory responses. Our results show that immunological differences between these populations cannot be explained by immediate environment alone and may reflect genetic, maternal or early-life effects. Additionally, they suggest that cytokines play a role in shaping immunological variation among wild vertebrates.

Avoidance of physical activity is a sensitive indicator of illness.

Although fever and sickness behavior are common responses to infection, it has been proposed that the sickness behaviors associated with infection, in particular lethargy and fatigue, may be more valuable clinical markers of illness and recovery in patients, than is body temperature alone. Measuring abdominal temperature, food intake and wheel running we therefore determined the dose thresholds and sensitivities of these responses to lipopolysaccharide (LPS). Male Sprague-Dawley rats were randomly assigned to receive one of three LPS doses (10, 50, 250 microg/kg), or saline, subcutaneously. Administration of LPS induced a dose-dependent increase in abdominal temperature and decrease in wheel running, food intake and body mass. Regression analysis revealed that decreased running was the most-sensitive of the sickness responses to LPS administration, with a regression slope of -41%/log microg, compared to the slopes for food intake (-30%/log microg, F(1,2)=244, P=0.004) and body mass (-2.2%/log microg, F(1,5)=7491, P<0.0001). To determine the likelihood that exercise training influenced the sickness responses we measured in our dose-response study we performed a second experiment in which we investigated whether fever and anorexia induced by LPS administration would present differently depending on whether rats had been exercising or sedentary. Six weeks of wheel running had no effect on the magnitude of fever and anorexia induced by LPS administration. Avoidance of physical activity therefore appears to be a more-sensitive indicator of a host's reaction to LPS than is anorexia and fever.