Delayed onset of severe chronic pain in CASPR2 autoantibody-associated Morvan syndrome in a former UK swine abattoir worker

Goebel, Andreas ORCID: 0000-0002-3763-8206, Moore, Austen Peter and Jacob, Anu (2018) Delayed onset of severe chronic pain in CASPR2 autoantibody-associated Morvan syndrome in a former UK swine abattoir worker. PAIN REPORTS, 3 (5). e675-.

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Abstract

<h4>Introduction</h4>Autoantibody-mediated autoimmunity directed against targets within the voltage-gated potassium channel complex (VGKCC autoantibodies) has been implicated in causing neuropathic pain.<h4>Methods</h4>We report the case of a 76-year-old, United Kingdom male who was diagnosed with contactin-associated protein 2 (CASPR2) autoantibody-associated Morvan syndrome, a rare neurological condition.<h4>Results</h4>He had previously worked in a swine abattoir; exposure to aerosol within swine abattoirs has been reported to elicit an immune response resulting in the production of these autoantibodies; however, unusually, his manifestations emerged with several years' latency. Although this patient's Morvan syndrome-associated seizures were well-controlled with antiepileptic drugs, his neuropathic pain and painful muscle fasciculations did not respond to pharmacological interventions. He refused pain management program treatment, but high-dose immunoglobulin treatment or treatment with rituximab, reported to be sometimes effective in this group, was not initiated because of concerns regarding his general frailty.<h4>Discussion and conclusion</h4>This case highlights issues around the identification and treatment of rare patients with chronic pain who have voltage-gated potassium channel complex autoantibodies; it also emphasizes the possibility that former swine abattoir workers might be at risk of developing neuropathic pain even years after their vocational exposure.

Item Type:	Article
Uncontrolled Keywords:	Neuropathic pain, CASPR2, Morvan syndrome, Abattoir
Depositing User:	Symplectic Admin
Date Deposited:	25 Jan 2019 11:24
Last Modified:	19 Jan 2023 01:08
DOI:	10.1097/PR9.0000000000000675
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3030725