Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Progressive Encephalomyelitis with Rigidity and Myoclonus Resolving after Thymectomy with Subsequent Anasarca: An Autopsy Case
Kokoro OzakiTakuya OhkuboTetsuo YamadaKotaro YoshiokaMasahiko IchijoTakamasa MajimaShunsuke KudoTakumi AkashiKeiji HondaEisaku ItoMayumi WatanabeMasaki SekineMiwako HamagakiYoshinobu EishiNobuo SanjoSatoru IshibashiHidehiro MizusawaTakanori Yokota
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JOURNALS OPEN ACCESS

2018 Volume 57 Issue 23 Pages 3451-3458

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Abstract

Progressive encephalomyelitis with rigidity and myoclonus (PERM) is an autoimmune disorder involving the brainstem and spinal cord and is sometimes associated with thymoma. We encountered a 75-year-old woman with typical PERM features, glycine receptor antibody, and thymoma. Her neurologic symptoms improved after thymectomy, but she unexpectedly developed anasarca with massive pleural effusions and hypoalbuminemia and finally succumbed to death. The autopsy showed edema and mononuclear infiltration in the pleura but no neuropathological findings typical of PERM. Effective treatment of PERM can reverse the neuropathological signs of encephalomyelitis. The autoimmune nature of anasarca is possible but not proven.

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© 2018 by The Japanese Society of Internal Medicine
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