CANOMAD syndrome

Overview

A rare syndrome characterized by a range of abnormalities caused by immune-mediated nerve demyelination. There is usually no loss of limb function associated with the disorder. The face, throat, mouth and eye symptoms (weakness of the muscles) usually come and go

Symptoms

* Chronic sensory neuropathy * Sensory ataxia * Loss of balance in the dark * Loss of balance when eyes closed * Absent tendon reflexes

Causes

CANOMAD syndrome usually develops as a result of the production of a specific IgM antibody directed against the I/i antigens (precursors of the ABH and Lewis blood group substances) on RBCs. It is caused by the body mistakenly making antibodies (of the IgM type) against a component of red blood cells

Prognosis

Infants and children are rarely affected with chronic CAD, although M pneumoniae and infectious mononucleosis are diseases of young persons. Chronic CAD appears to affect adults who are of middle age and older, with an average age more commonly older than 60 years (peaking in the seventh and eighth decades of life). Although found in persons of all age groups, mixed autoimmune hemolysis is also more frequent in later life.

Treatment

* The following may provide temporary relief in some cases: plasma exchange * Intravenous immunoglobulin * Corticosteroids * Beta-interferons * Cytotoxic drugs