Delayed onset of severe chronic pain in CASPR2 autoantibody–associated Morvan syndrome in a former UK swine abattoir worker
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 co...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2018-10-01
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| Series: | PAIN Reports |
| Online Access: | http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000000675 |
| _version_ | 1818689327889121280 |
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| author | Andreas Goebel Austen Peter Moore Anu Jacob |
| author_facet | Andreas Goebel Austen Peter Moore Anu Jacob |
| author_sort | Andreas Goebel |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-17T12:08:21Z |
| format | Article |
| id | doaj.art-e569ff64c863408fa573ebf368a186d4 |
| institution | Directory Open Access Journal |
| issn | 2471-2531 |
| language | English |
| last_indexed | 2024-12-17T12:08:21Z |
| publishDate | 2018-10-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | PAIN Reports |
| spelling | doaj.art-e569ff64c863408fa573ebf368a186d42022-12-21T21:49:32ZengWolters KluwerPAIN Reports2471-25312018-10-0135e67510.1097/PR9.0000000000000675201810000-00001Delayed onset of severe chronic pain in CASPR2 autoantibody–associated Morvan syndrome in a former UK swine abattoir workerAndreas Goebel0Austen Peter Moore1Anu Jacob2a Pain Research Institute, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdomc Neurology, Walton Centre NHS Foundation Trust, Liverpool, United Kingdomc Neurology, Walton Centre NHS Foundation Trust, Liverpool, United KingdomAbstract. 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.http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000000675 |
| spellingShingle | Andreas Goebel Austen Peter Moore Anu Jacob Delayed onset of severe chronic pain in CASPR2 autoantibody–associated Morvan syndrome in a former UK swine abattoir worker PAIN Reports |
| title | Delayed onset of severe chronic pain in CASPR2 autoantibody–associated Morvan syndrome in a former UK swine abattoir worker |
| title_full | Delayed onset of severe chronic pain in CASPR2 autoantibody–associated Morvan syndrome in a former UK swine abattoir worker |
| title_fullStr | Delayed onset of severe chronic pain in CASPR2 autoantibody–associated Morvan syndrome in a former UK swine abattoir worker |
| title_full_unstemmed | Delayed onset of severe chronic pain in CASPR2 autoantibody–associated Morvan syndrome in a former UK swine abattoir worker |
| title_short | Delayed onset of severe chronic pain in CASPR2 autoantibody–associated Morvan syndrome in a former UK swine abattoir worker |
| title_sort | delayed onset of severe chronic pain in caspr2 autoantibody associated morvan syndrome in a former uk swine abattoir worker |
| url | http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000000675 |
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