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Acquired hepatocerebral degeneration revealed by neurogenic hyperventilation syndrome and myelitis
  1. Nicolas Carriere1,2,
  2. Adeline Rollin1,3,
  3. Clemence Simonin1,2,4,
  4. Pierre Labauge5
  1. 1University Lille Nord de France, UDSL, Lille, France
  2. 2Department of Neurology and Movement Disorders Clinic, Lille University Hospital, Lille, France
  3. 3EA 1046, Memory Clinic, Lille University Hospital, Lille, France
  4. 4UMR837 Team 6 INSERM, University Lille, France
  5. 5Department of Neurology, Montpellier University Medical Center, Gui de Chauliac Hospital, Montpellier, France
  1. Correspondence to Dr Nicolas Carriere, Service de Neurologie et Pathologies du Mouvement, HÃ'pital Roger Salengro, CHRU Lille, Rue Emile Laine, F-59037 Lille Cedex, France; nicolas.carriere{at}chru-lille.fr

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A 46-year-old woman with a history of kidney transplant for IgA nephropathy (on tacrolimus and mycophenolate mofetil), type II diabetes and non-alcoholic steatohepatitis was admitted for gait instability. Neurological examination revealed lower limb sensory ataxia and brisk patellar reflexes. Brain/spinal MRI results were normal. Blood tests disclosed macrocytosis (but no vitamin deficiencies) and mild hepatic cytolysis. Lumbar puncture showed the absence of cells, normal protein, hypoglycorrhachia (glycorrhachia: 0.62 g/l; glycaemia: 1.65 g/l) and no oligoclonal bands. Cerebrospinal fluid cultures were negative. Assays for neurotropic viruses, paraneoplastic …

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