Depression of spinal motoneurons may underlie weakness associated with severe anemia.

Abstract

A 37-year-old woman had a 2-week history of progressive weakness, muscle hypotonia, and absent or hypoactive deep tendon reflexes. Nerve conduction studies showed diminished H-reflexes and absent or decreased persistence of F-waves in all limbs. The patient was admitted to the hospital with a diagnosis of Guillain-Barré syndrome. Laboratory studies revealed severe anemia with a hemoglobin level of 4.1 g/dl and hematocrit of 15.1%. Immediate blood transfusion resulted in a hemoglobin of 13.2 g/dl and hematocrit of 40.2%, associated with rapid neurological recovery (normal stretch reflexes and muscle strength) and normalization of F-waves and H-reflexes. This case demonstrates that severe anemia may be associated with signs and symptoms that mimic Guillain-Barré syndrome, both clinically and electrophysiologically. It also suggests that a relative depression of spinal motoneuron excitability may be a possible mechanism for the weakness that is commonly observed in severe anemia.

• Authors: A Arturo Leis, Dobrivoje S Stokic, Jinna M Shepherd
• Journal: Muscle & nerve (Muscle Nerve) Vol. 27 Issue 1 Pg. 108-12 (Jan 2003) ISSN: 0148-639X [Print] United States
• PMID: 12508304 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Anemia (complications, physiopathology)
• Female
• H-Reflex
• Humans
• Motor Neurons (physiology)
• Muscle Weakness (etiology, physiopathology)
• Neural Conduction