ABSTRACT
Tabes dorsalis is uncommon and progresses slowly from infection to clinical manifestation. We report a rare case of rapidly progressive tabes dorsalis associated with selective IgA deficiency (sIgAD). A 28-year-old man was hospitalized with lightning back pain, nausea, and bladder bowel dysfunction. Serum and cerebrospinal fluid (CSF) revealed high titers of Treponema pallidum antibody, and the serum IgA level was less than 5 mg/dl. Thl-dominant cytokine expression was observed, as is usually seen in neurosyphilis. He was treated with Ceftriaxone and CSF pleocytosis disappeared. We postulate sIgAD influenced the atypical rapid clinical course of tabes dorsalis in this patient.
Subject(s)
IgA Deficiency/complications , Tabes Dorsalis/immunology , Tabes Dorsalis/pathology , Adult , Disease Progression , Humans , IgA Deficiency/blood , Magnetic Resonance Imaging , Male , Tabes Dorsalis/blood , Tabes Dorsalis/complications , Treponema pallidum/isolation & purificationABSTRACT
Significant cellular sensitivity to peripheral nerve antigens was found by MIF assay in 36% of patients with lung cancer (P<0·005) as compared with 62% of patients with peripheral neuropathy without neoplasia. No sensitivity was found in controls or the cancer sub-group without neuromuscular abnormality. The significance of these findings for an immune mechanism is discussed.
