Neuronal intranuclear inclusion disease with mental abnormality: a case report
Abstract Background Neuronal intranuclear inclusion disease (NIID) is a chronic progressive neurodegenerative disease that is characterized by the discovery of eosinophilic hyaline intranuclear inclusions in the central and peripheral nervous systems and visceral organs. In this paper, we report a c...
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| Language: | English |
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BMC
2020-09-01
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| Series: | BMC Neurology |
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| Online Access: | http://link.springer.com/article/10.1186/s12883-020-01933-8 |
| _version_ | 1818501089862877184 |
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| author | Xiaosa Chi Man Li Ting Huang Kangyong Tong Hongyi Xing Jixiang Chen |
| author_facet | Xiaosa Chi Man Li Ting Huang Kangyong Tong Hongyi Xing Jixiang Chen |
| author_sort | Xiaosa Chi |
| collection | DOAJ |
| description | Abstract Background Neuronal intranuclear inclusion disease (NIID) is a chronic progressive neurodegenerative disease that is characterized by the discovery of eosinophilic hyaline intranuclear inclusions in the central and peripheral nervous systems and visceral organs. In this paper, we report a case of an adult-onset neuronal intranuclear inclusion disease presenting with mental abnormality in China. Case presentation A 62-year-old woman presented with mental abnormality and forgetfulness for 3 months before she was admitted to our hospital. There were prodromal symptoms of fever before she had the mental disorder. Encephalitis was first suspected, and the patient underwent lumbar puncture and brain magnetic resonance imaging (MRI). A cerebrospinal fluid (CSF) examination indicated normal pressure, a normal white blood cell count, and slightly elevated protein and glucose levels. Coxsackie B virus, enterovirus, and cytomegalovirus tests showed normal results. Bacterial culture and Cryptococcus neoformans test results were negative. The contrast-enhanced MRI of the brain was normal. The brain diffusion-weighted imaging (DWI) showed a symmetrically distributed strip-shaped hyperintensity signal of the corticomedullary junction in the bilateral frontal, parietal, and temporal lobes. We considered the diagnosis of the NIID, and therefore, skin biopsy was performed. The electron microscopy revealed that intranuclear inclusions in the nucleus of fibrocytes existed and were composed of filaments. Conclusions NIID is a rare neurodegenerative disease with diverse clinical manifestations. In clinical work, when a patient presents with abnormal mental behavior and exhibits hyperintensity signals on DWI images of the corticomedullary junction, it is crucial to consider the diagnosis of NIID. |
| first_indexed | 2024-12-10T20:51:27Z |
| format | Article |
| id | doaj.art-bc864d6cf4034e36a505cd18f4d9d22b |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-10T20:51:27Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-bc864d6cf4034e36a505cd18f4d9d22b2022-12-22T01:34:05ZengBMCBMC Neurology1471-23772020-09-012011510.1186/s12883-020-01933-8Neuronal intranuclear inclusion disease with mental abnormality: a case reportXiaosa Chi0Man Li1Ting Huang2Kangyong Tong3Hongyi Xing4Jixiang Chen5Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Neurology, The First People’s Hospital of ZaoyangDepartment of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Background Neuronal intranuclear inclusion disease (NIID) is a chronic progressive neurodegenerative disease that is characterized by the discovery of eosinophilic hyaline intranuclear inclusions in the central and peripheral nervous systems and visceral organs. In this paper, we report a case of an adult-onset neuronal intranuclear inclusion disease presenting with mental abnormality in China. Case presentation A 62-year-old woman presented with mental abnormality and forgetfulness for 3 months before she was admitted to our hospital. There were prodromal symptoms of fever before she had the mental disorder. Encephalitis was first suspected, and the patient underwent lumbar puncture and brain magnetic resonance imaging (MRI). A cerebrospinal fluid (CSF) examination indicated normal pressure, a normal white blood cell count, and slightly elevated protein and glucose levels. Coxsackie B virus, enterovirus, and cytomegalovirus tests showed normal results. Bacterial culture and Cryptococcus neoformans test results were negative. The contrast-enhanced MRI of the brain was normal. The brain diffusion-weighted imaging (DWI) showed a symmetrically distributed strip-shaped hyperintensity signal of the corticomedullary junction in the bilateral frontal, parietal, and temporal lobes. We considered the diagnosis of the NIID, and therefore, skin biopsy was performed. The electron microscopy revealed that intranuclear inclusions in the nucleus of fibrocytes existed and were composed of filaments. Conclusions NIID is a rare neurodegenerative disease with diverse clinical manifestations. In clinical work, when a patient presents with abnormal mental behavior and exhibits hyperintensity signals on DWI images of the corticomedullary junction, it is crucial to consider the diagnosis of NIID.http://link.springer.com/article/10.1186/s12883-020-01933-8Neuronal intranuclear inclusion diseaseMental abnormalitySkin biopsyIntranuclear inclusion |
| spellingShingle | Xiaosa Chi Man Li Ting Huang Kangyong Tong Hongyi Xing Jixiang Chen Neuronal intranuclear inclusion disease with mental abnormality: a case report BMC Neurology Neuronal intranuclear inclusion disease Mental abnormality Skin biopsy Intranuclear inclusion |
| title | Neuronal intranuclear inclusion disease with mental abnormality: a case report |
| title_full | Neuronal intranuclear inclusion disease with mental abnormality: a case report |
| title_fullStr | Neuronal intranuclear inclusion disease with mental abnormality: a case report |
| title_full_unstemmed | Neuronal intranuclear inclusion disease with mental abnormality: a case report |
| title_short | Neuronal intranuclear inclusion disease with mental abnormality: a case report |
| title_sort | neuronal intranuclear inclusion disease with mental abnormality a case report |
| topic | Neuronal intranuclear inclusion disease Mental abnormality Skin biopsy Intranuclear inclusion |
| url | http://link.springer.com/article/10.1186/s12883-020-01933-8 |
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