To determine clinical features of neurologic disorders associated with anti-glutamic acid decarboxylase antibodies (anti-GAD-Ab), we examined titers and time-dependent changes of anti-GAD-Ab. Six patients, stiff person syndrome (2), cerebellar ataxia (1), limbic encephalitis (1), epilepsy (1), brainstem encephalitis (1), were compared with 87 type I diabetes mellitus (T1DM) patients without neurologic disorders. Anti-GAD-Ab titers and index were higher in neurologic disorders than in T1DM, suggesting intrathecal antibody synthesis.
View Article and Find Full Text PDFWe present a case of refractory Cryptococcus neoformans meningoencephalitis in an immunocompetent woman. Her clinical symptoms did not improve with 6 months of antifungal therapy, and MRI abnormalities, indicating severe meningeal and cerebral inflammation, persisted despite a decreasing cryptococcal antigen titer. The patient continued to deteriorate despite antifungal therapy, and her condition clearly improved following treatment with adjunctive corticosteroid.
View Article and Find Full Text PDFThe aim of the present study was to investigate the prevalence of fear of hypoglycemia, in association with severe hypoglycemia and social factors, in insulin-treated patients with type 2 diabetes mellitus. A questionnaire survey on hypoglycemia and patient-physician communication was carried out in 355 patients with insulin-treated type 2 diabetes mellitus patients at 16 hospitals and clinics. A fear of hypoglycemia was reported by 27.
View Article and Find Full Text PDFRinsho Shinkeigaku
February 2014
We report the case of a 65-year-old woman who presented with Churg-Strauss syndrome (CSS) associated with multiple cerebral infarcts. Four years ago, she was diagnosed as having CSS based on asthma, hypereosinophilia and peripheral neuropathy, and corticosteroid therapy achieved a remission. However, she showed exacerbation of asthma and hypereosinophilia during the tapering schedule of steroid, and she was hospitalized because of dizziness and mild left side weakness.
View Article and Find Full Text PDFAim: Glucagon is recommended to treat severe hypoglycemia in nonhospital environments, when a patient with type 1 diabetes mellitus (T1DM) is unconscious and unable to eat or drink. However, the actual possession rate of glucagon in Japan has not been investigated.
Subjects And Methods: We recruited 208 T1DM patients older than 15 years of age.
Background: Oxidative stress/free radical generation after ischemic stroke contributes to neuronal cell injury. We evaluated the utility of an oxidative stress marker, urinary 8-hydroxy-2-deoxyguanosine (8-OHdG), to demonstrate an association between the changes of 8-OHdG and outcomes after acute ischemic stroke.
Methods: We enrolled 44 patients (26 males and 18 females) who visited our hospital due to acute ischemic stroke.
Diabetes Res Clin Pract
August 2012
Insulin allergy is a rare complication of insulin therapy. Proper management, though difficult, is critical. Here, we report the case of a patient with type 2 diabetes and insulin allergy, successfully treated with continuous subcutaneous insulin infusion (CSII).
View Article and Find Full Text PDFWe report the case of an 18-year-old boy who presented with disturbance of consciousness and generalized seizures following flu-like symptoms such as high fever and arthralgia. T2 and diffusion weighted brain magnetic resonance images showed a hyperintense ovoid lesion in the splenium of the corpus callosum and T, weighted images showed a hypointense lesion; the lesion completely disappeared on repeat imaging after 3 days. Antiglutamate epsilon2 receptor antibodies were detected in his cerebrospinal fluid.
View Article and Find Full Text PDFe report an 87-year-old woman who presented with incomplete Brown-Séquard syndrome after reactivation of varicella-zoster virus (VZV). Two days after herpes zoster in the right side of the chest, she developed weakness of the right lower limb. Neurological examination revealed a spastic palsy in the right lower limb and left side loss of pain and temperature sense to T6.
View Article and Find Full Text PDFWe report the case of a 31-year-old woman who presented with neuromyelitis optica (NMO) associated with Sjögren syndrome and distal renal tubular acidosis. She was hospitalized because of cervical transverse myelopathy and right optic neuritis. She had been clinically diagnosed with Sj6gren syndrome, with a high titer of anti-SS-A antibody (1:500) and anti-SS-B antibody (1:498).
View Article and Find Full Text PDFSolitary fibrous tumor is an uncommon mesenchymal lesion, seldom associated with hypoglycemia and rarely presents as a retroperitoneal tumor. We present a case in a 56-year-old male patient whose initial symptom was unconsciousness due to hypoglycemia (blood glucose 16 mg/dl). Computed tomography indicated a mass (about 20 x 15 x 15 cm) in the retroperitoneum.
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