Asthma Allergy Immunology

Asthma Allergy Immunology

2015, Vol 13, Num, 1     (Pages: 050-054)

Hopkins` syndrome: a case report and review of the literature

Öner ÖZDEMİR 1, Dilek BİNGÖL AYDIN 2, Fatma Banu TURHAN 3,

1 Sakarya Eğitim ve Araştırma Hastanesi, Çocuk Alerji İmmünoloji Kliniği, Sakarya, Türkiye
2 Sakarya Eğitim ve Araştırma Hastanesi, Çocuk Sağlığı ve Hastalıkları, Sakarya, Türkiye
3 Sakarya Üniversitesi Tıp Fakültesi, Sakarya, Türkiye

DOI: 10.5578/aai.9195
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Hopkins` syndrome is a motor neuron disease which leads to a fl accid paralysis due to anterior horn cell damage and normal sensation aff ecting one or more limbs resembling poliomyelitis. It occurs less than one week aft er an asthma attack and its prognosis is poor. Although there has been no satisfactory explanation for the etiology; drug neurotoxicity, steroids and viruses (enteroviruses, Mycoplasma and Herpes simplex) have been implicated. Here, a rarely seen male patient having Hopkins` syndrome was described. A fi ve year old male with persistent asthma, allergic rhinitis and atopic dermatitis presented to us with left lower extremity (LLE) fl accid paralysis and hyporefl exia. Th ree weeks earlier, he was treated for an exacerbation of asthma with-7-day course of oral prednisone, fl uticason and albuterol nebules with improvement. However, he had another attack one dav prior to fl accid paralysis. His weakness began with pain and paraesthesia in that morning. He then started to limp and was unable to stand or walk on that left leg a couple of hours later. Physical examination revealed fl accid and arefl exic LLE on admission. Plantar refl exes, sensation, hip movements on both lower extremities and sphincter tone were normal. Several months later, he walked with a limp and had persistent LLE weakness and muscle atrophy. CBC, routine biochemistry, CRP, ESR, CPK, toxicology screen and urine analvsis were within normal. lgM to EBV, CMV and PCR for enteroviruses were negative. Specifi c IgE was positive for dust mite. CSF showed normal fi ndings. MRI of spine/pelvis/cranium and both extremities was normal. EMG revealed anterior horn cell damage. Hopkins` syndrome should be kept in mind in the diff erential diagnosis of any fl accid paralvsis associated with an asthma attack.

Keywords : Hopkins` syndrome, asthma attack, anterior horn cell damage, motor neuron disease