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J Neurol Neurosurg Psychiatry. 2006 Apr;77(4):507-12.

Post-streptococcal opsoclonus-myoclonus syndrome associated with anti-neuroleukin antibodies.

Author information

  • 1Department of Neuroinflammation, Institute of Neurology, Queen Square, London, WC1N 3BG, UK. p.candler@ion.ucl.ac.uk

Abstract

BACKGROUND:

Adult opsoclonus-myoclonus (OM), a disorder of eye movements accompanied by myoclonus affecting the trunk, limbs, or head, is commonly associated with an underlying malignancy or precipitated by viral infection.

METHODS:

We present the first two reports of post-streptococcal OM associated with antibodies against a 56 kDa protein. Two young girls presented with opsoclonus and myoclonus following a febrile illness and pharyngitis. Protein purification techniques were employed. Amino acid sequences of human neuroleukin (NLK) and streptococcal proteins were compared using the protein-protein BLAST application.

RESULTS:

The antigen was identified as NLK (glucose-6-phosphate isomerase, GPI). GPI is present on the cell surface of streptococcus making the protein a candidate target for molecular mimicry.

CONCLUSIONS:

We have identified NLK as an antigenic target in two patients with post-streptococcal OM. The pathogenicity of the antibodies is uncertain. The potential role of anti-neuroleukin antibodies in the pathogenesis of OM is discussed. We propose that OM may represent a further syndrome in the growing spectrum of post-streptococcal neurological disorders. The role of streptococcus in OM and the frequency with which anti-NLK responses occur in both post-infectious and paraneoplastic OM should be investigated further.

PMID:
16543530
[PubMed - indexed for MEDLINE]
PMCID:
PMC2077526
Free PMC Article

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