A Case of Anti-IgLON5 Disease with Aplastic Anemia and review of the literature

Abbas Tafakhori; Seyyed Reza Ebadi; Hamed Amirifard; Saeed Karima; Arian Hasani; Nazanin Esmaeili

doi:10.18502/crcp.v8i6.16234

Abbas Tafakhori LTM Unit, Neurology Department, Neurology Building, Imam Khomeini Hospital Complex, East Baqer Khaan Street, Tehran, Iran
Seyyed Reza Ebadi Deparment of Neurology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Hamed Amirifard Deparment of Neurology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Saeed Karima Deparment of Biochemistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Arian Hasani Tehran Heart center, Tehran University of Medical Sciences, Tehran, Iran
Nazanin Esmaeili InPedia association, Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/crcp.v8i6.16234

Keywords: Neurology; Autoimmune; Sleep Disorders; Dementia; Anti-IgLON5

Abstract

Anti-IgLON5 is a neurological condition with neurodegenerative and autoimmune etiology. A 64-year-old man with a 2-year history of aplastic anemia presented with symmetrical parkinsonism, fluctuating consciousness, supranuclear gaze palsy, mild fasciculation, and muscular atrophy. He had disturbances in his sleep cycle and brain MRI. CSF analysis was positive for the IgLON5 antibody. We initiated immunotherapy with high-dose methylprednisolone, intravenous immunoglobulin, and rituximab. The patient showed a mild to moderate response to treatment. We reviewed 29 published case reports regarding anti-Iglon-5 and examined the clinical manifestation. None of the cases showed aplastic anemia, which was the main presentation in our case. All of the patients experienced sleep disturbances, while other symptoms were heterogeneous. Anti-Iglon-5 is usually diagnosed late, leading to a weak prognosis. This study helped us establish a better understanding of the correlation between antiIglon5 disease and other autoimmune disorders like anemia.