Depression of spinal motoneurons may underlie weakness associated with severe anemia
Autor(es): Leis A Arturo,Stokic Dobrivoje S,Shepherd Jinna M
Resumo: A 37-year-old woman had a 2-week history of progressive weakness, muscle hypotonia, and absent or hypoactive deep tendon reflexes. Nerve conduction studies showed diminished H-reflexes and absent or decreased persistence of F-waves in all limbs. The patient was admitted to the hospital with a diagnosis of Guillain-Barré syndrome. Laboratory studies revealed severe anemia with a hemoglobin level of 4.1 g/dl and hematocrit of 15.1%. Immediate blood transfusion resulted in a hemoglobin of 13.2 g/dl and hematocrit of 40.2%, associated with rapid neurological recovery (normal stretch reflexes and muscle strength) and normalization of F-waves and H-reflexes. This case demonstrates that severe anemia may be associated with signs and symptoms that mimic Guillain-Barré syndrome, both clinically and electrophysiologically. It also suggests that a relative depression of spinal motoneuron excitability may be a possible mechanism for the weakness that is commonly observed in severe anemia.
Palavras-Chave: Anemia; F-waves; H-re?exes; Spinal motoneuron excitability
Imprenta: Muscle & Nerve, v. 27, n. 1, p. 108-112, 2003
Identificador do objeto digital: 10.1002/mus.10288
Descritores: Guillain-Barre Syndrome - Cell ; Guillain-Barre Syndrome - Pathogenesis
Data de publicação: 2003
