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CASE REPORT
Proteinase 3-antineutrophil cytoplasmic antibody-positive ulcerative colitis presenting with abducens neuropathy
  1. Yuki Kirito,
  2. Daisuke Yamamoto,
  3. Tsuyoshi Uchiyama
  1. Department of Neurology, Seirei Hamamatu General Hospital, Hamamatsu, Shizuoka, Japan
  1. Correspondence to Dr Daisuke Yamamoto; daisuke-yama{at}sis.seirei.or.jp

Summary

A 72-year-old man with ulcerative colitis (UC) presented with complete left abducens nerve palsy. Although MRI showed no significant changes, cerebrospinal fluid analysis revealed pleocytosis and elevated protein and interleukin (IL)-6 levels. His serum proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA) level was also elevated to 31.1 U/mL, but granulomatosis with polyangiitis was not observed. On the basis of the diagnosis of autoimmune cranial neuropathy, he was treated with steroid therapy. While tapering steroid therapy, his serum PR3-ANCA levels; cerebrospinal fluid findings, including IL-6 levels; and symptoms improved. Serum PR3-ANCA could be a useful parameter of neurological disorders associated with ANCA-positive UC.

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Footnotes

  • Contributors YK is a major contributor in writing the manuscript. DY and TU also treated the patient and interpreted the patient data. All authors read and approved the final manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.