Immunotherapy-responsive pain in an abattoir worker with fluctuating potassium channel-complex IgG.

摘要

In late 2007, a neurologic disorder was identified in the midwestern United States among swine abattoir workers who were exposed to aerosolized brain tissue. All patients reported positive sensory symptoms with pain. Neurologic signs and electrophysiologic testing abnormalities were limited and compatible with a sensory-predominant painful polyradiculoneuropathy. Serologic analysis revealed an unusual profile of neural-specific autoantibodies. Here we describe an early presenting case from this outbreak who was followed longitudinally with pain-predominant symptomatology, a newly recognized manifestation of voltage-gated potassium channel (VGKC)-complex autoimmunky. In the course of IV immune globulin therapy, the patient's pain symptoms paralleled fluctuating levels of VGKC-complex autoantibodies.