UNASSIGNED: A 45-year-old male with asthma developed acute quadriparesis one week after receiving the first dose of omalizumab. Electrophysiological studies have shown partial motor conduction block in multiple nerves, with reduced CMAP amplitudes and absent F-waves in others. CSF showed cyto-albuminous dissociation. The diagnosis was a variant of Guillain-Barré syndrome. Despite intravenous immunoglobulin (IVIG) therapy, the patient experienced persistent neuropathic symptoms.
UNASSIGNED: The patient presented with acute quadriparesis devoid of sensory or cranial nerve involvement, suggestive of a variant of Guillain-Barré syndrome (GBS) known as acute motor conduction block neuropathy (AMCBN). Electrophysiological studies have indicated conduction block without demyelination, implicating axonal degeneration. Despite negative findings for common etiologies, the temporal association between omalizumab administration and symptom onset suggests a potential link, supported by criteria for drug-induced illness. Conflicting evidence exists regarding omalizumab\'s neurological effects, with proposed mechanisms including autoimmune reactions and mast cell dysfunction. Comparisons to TNF-α antagonists highlight similar neuropathy patterns, indicating a need for further research to clarify omalizumab\'s neurotoxicity.
UNASSIGNED: In conclusion, while omalizumab holds promise for allergic conditions, including chronic urticaria, its potential impact on peripheral nerves necessitates vigilance among clinicians. Further studies are imperative to ascertain the risk-benefit profile and elucidate underlying mechanisms and risk factors of neurological complications associated with omalizumab therapy.
■一名45岁男性哮喘患者在接受第一剂奥马珠单抗治疗一周后出现急性四肢瘫痪。电生理研究表明,多条神经的部分运动传导阻滞,具有降低的CMAP振幅和缺乏F波。CSF显示细胞-白蛋白解离。诊断为格林-巴利综合征。尽管静脉注射免疫球蛋白(IVIG)治疗,患者出现持续性神经性症状.
■患者出现急性四肢轻瘫,没有感觉或颅神经受累,提示一种称为急性运动传导阻滞神经病(AMCBN)的格林-巴利综合征(GBS)变体。电生理研究表明无脱髓鞘的传导阻滞,涉及轴突变性。尽管常见病因的阴性结果,奥马珠单抗给药和症状发作之间的时间关联表明存在潜在的联系,由药物引起的疾病标准支持。关于奥马珠单抗的神经效应存在矛盾的证据,提出的机制包括自身免疫反应和肥大细胞功能障碍。与TNF-α拮抗剂的比较突出了相似的神经病变模式,表明需要进一步研究以阐明奥马珠单抗的神经毒性。
■总而言之,虽然奥马珠单抗对过敏疾病有希望,包括慢性荨麻疹,其对周围神经的潜在影响需要临床医生保持警惕.进一步的研究对于确定奥马珠单抗治疗相关的神经系统并发症的风险-收益概况和阐明潜在的机制和风险因素是必要的。