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Delayed onset of severe chronic pain in CASPR2 autoantibody–associated Morvan syndrome in a former UK swine abattoir worker
- Source :
- PAIN Reports, Vol 3, Iss 5, p e675 (2018)
- Publication Year :
- 2018
- Publisher :
- Wolters Kluwer, 2018.
-
Abstract
- Abstract. Introduction:. Autoantibody-mediated autoimmunity directed against targets within the voltage-gated potassium channel complex (VGKCC autoantibodies) has been implicated in causing neuropathic pain. Methods:. We report the case of a 76-year-old, United Kingdom male who was diagnosed with contactin-associated protein 2 (CASPR2) autoantibody–associated Morvan syndrome, a rare neurological condition. Results:. He had previously worked in a swine abattoir; exposure to aerosol within swine abattoirs has been reported to elicit an immune response resulting in the production of these autoantibodies; however, unusually, his manifestations emerged with several years' latency. Although this patient's Morvan syndrome–associated seizures were well-controlled with antiepileptic drugs, his neuropathic pain and painful muscle fasciculations did not respond to pharmacological interventions. He refused pain management program treatment, but high-dose immunoglobulin treatment or treatment with rituximab, reported to be sometimes effective in this group, was not initiated because of concerns regarding his general frailty. Discussion and Conclusion:. This case highlights issues around the identification and treatment of rare patients with chronic pain who have voltage-gated potassium channel complex autoantibodies; it also emphasizes the possibility that former swine abattoir workers might be at risk of developing neuropathic pain even years after their vocational exposure.
- Subjects :
- Anesthesiology
RD78.3-87.3
Subjects
Details
- Language :
- English
- ISSN :
- 24712531 and 00000000
- Volume :
- 3
- Issue :
- 5
- Database :
- Directory of Open Access Journals
- Journal :
- PAIN Reports
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.569ff64c863408fa573ebf368a186d4
- Document Type :
- article
- Full Text :
- https://doi.org/10.1097/PR9.0000000000000675