A Case of Miller Fisher Syndrome in a Pediatric Patient with Positive Anti-GQ1b IgG

Eun Jee Kim; Suk Gyu Ha; Seung Hyun Kim

doi:10.3341/jkos.2016.57.3.528

Journal List > J Korean Ophthalmol Soc > v.57(3) > 1010545

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Kim, Ha, and Kim: A Case of Miller Fisher Syndrome in a Pediatric Patient with Positive Anti-GQ1b IgG

Case Report

J Korean Ophthalmol Soc 2016;57(3):528-531.

Published online: 3 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.3.528

A Case of Miller Fisher Syndrome in a Pediatric Patient with Positive Anti-GQ1b IgG

Eun Jee Kim, MD, Suk Gyu Ha, MD, Seung Hyun Kim, MD, PhD

Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea

Address reprint requests to Seung Hyun Kim, MD, PhD, Department of Ophthalmology, Korea University Anam Hospital, #73 Inchon-ro, Seongbuk-gu, Seoul 02841, Korea, Tel: 82-2-920-5521, Fax: 82-2-924-6820, E-mail: ansaneye@hanmail.net

Received 12 November 2015 Revised 12 December 2015 Accepted 1 February 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of Miller Fisher syndrome in a pediatric patient with gastroenteritis associated with seroconversion of Campylobacter jejuni titer during the development of neurological symptoms and positive anti-GQ1b IgG.

Case summary

An 8-year-old male patient visited our clinic with bilateral ophthalmoplegia, diplopia, and ptosis of the right upper lid. He had experienced gastroenteritis one week previous, and antibodies to Campylobacter jejuni were detected in his plasma. Ophthalmic examination revealed a corrected visual acuity of 20/20 in both eyes. Ocular motor examination revealed limitations in all positions of gaze. Neurologic examination demonstrated areflexia and ataxia. The serologic anti-GQ1b IgG test was positive. Intravenous immunoglobulin and steroid pulse therapy were started. Extraocular movement, ptosis, and ataxia gradually improved after one month of treatment.

Conclusions

We confirmed a case of Miller Fisher syndrome in a pediatric patient with bilateral ophthalmoplegia, ptosis, and a positive anti-GQ1b antibody test.

Keywords: Anti-GQ1b IgG antibody, Miller Fisher syndrome, Pediatric patient

References

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Figure 1.

Photographs of the patient at initial visit. Photographs of nine cardinal direction of gaze showed limitation in all positions of gaze.

Figure 2.

Photographs of the patient 10 days after treatment. Ocular motor examination revealed limitation of depression was improved than the other gaze limitation.

Figure 3.

Photographs of the patient 1 month after treatment. Ocular motor examination revealed limitation of all gaze was im proved.

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