Multiple-System Atrophy in Long-Term Professional Painter: A Case Report

Introduction. Multiple system atrophy (MSA) is a rare and severe adult-onset, sporadic, and progressive neurodegenerative disorder. Here, we describe an autopsy case of MSA in a long-term professional painter. Although typical glial cytoplasmic inclusion (GCI) was not observed in a routine histologi...

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Main Authors: Yusa Nagai, Riko Kitazawa, Miku Nakagawa, Munenori Komoda, Takeshi Kondo, Ryuma Haraguchi, Sohei Kitazawa
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Case Reports in Pathology
Online Access:http://dx.doi.org/10.1155/2012/613180
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author Yusa Nagai
Riko Kitazawa
Miku Nakagawa
Munenori Komoda
Takeshi Kondo
Ryuma Haraguchi
Sohei Kitazawa
author_facet Yusa Nagai
Riko Kitazawa
Miku Nakagawa
Munenori Komoda
Takeshi Kondo
Ryuma Haraguchi
Sohei Kitazawa
author_sort Yusa Nagai
collection DOAJ
description Introduction. Multiple system atrophy (MSA) is a rare and severe adult-onset, sporadic, and progressive neurodegenerative disorder. Here, we describe an autopsy case of MSA in a long-term professional painter. Although typical glial cytoplasmic inclusion (GCI) was not observed in a routine histological examination, strong α-synuclein immunostaining in the nucleus confirmed the diagnosis of MSA. Case Presentation. A 48-year-old Japanese man with a long occupational history of professional painter was sent to the emergency room, where he died of multiple organ failure. The patient had suffered tremors and inarticulateness at age 28, developed diabetes at 42 and was diagnosed with spinocerebellar degeneration at 46. A histopathological examination showed severe neuronal loss, gliosis, and tissue rarefaction in the paleostriatum, striate body of the substantia nigra, the pons, and the olivary nucleus of the upper medulla oblongata, intermediolateral of the spinal gray matter (sacral region). α-synuclein-positive GCI in oligodendroglia was occurred in the cerebral cortex, the midbrain, the medulla oblongata, and the spinal cord. These findings confirmed the presence of multiple-system atrophy (OPCA+SDS). Conclusion. Although the pathogenesis of MSA is still unclear, prolonged, and extensive exposure to organic solvents, together with a hyperglycemic morbidity attributed to diabetes, may have contributed to the onset and clinical course of the present case.
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spelling doaj-art-387e8cfdb2e34405b3862ca6319bf1942025-08-20T02:38:57ZengWileyCase Reports in Pathology2090-67812090-679X2012-01-01201210.1155/2012/613180613180Multiple-System Atrophy in Long-Term Professional Painter: A Case ReportYusa Nagai0Riko Kitazawa1Miku Nakagawa2Munenori Komoda3Takeshi Kondo4Ryuma Haraguchi5Sohei Kitazawa6Division of Molecular Pathology, Ehime University Graduate School of Medicine, Shitsukawa, Ehime, Toon City, 791-0295, JapanDivision of Molecular Pathology, Ehime University Graduate School of Medicine, Shitsukawa, Ehime, Toon City, 791-0295, JapanDivision of Molecular Pathology, Ehime University Graduate School of Medicine, Shitsukawa, Ehime, Toon City, 791-0295, JapanDivision of Molecular Pathology, Ehime University Graduate School of Medicine, Shitsukawa, Ehime, Toon City, 791-0295, JapanDepartment of Legal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDivision of Molecular Pathology, Ehime University Graduate School of Medicine, Shitsukawa, Ehime, Toon City, 791-0295, JapanDivision of Molecular Pathology, Ehime University Graduate School of Medicine, Shitsukawa, Ehime, Toon City, 791-0295, JapanIntroduction. Multiple system atrophy (MSA) is a rare and severe adult-onset, sporadic, and progressive neurodegenerative disorder. Here, we describe an autopsy case of MSA in a long-term professional painter. Although typical glial cytoplasmic inclusion (GCI) was not observed in a routine histological examination, strong α-synuclein immunostaining in the nucleus confirmed the diagnosis of MSA. Case Presentation. A 48-year-old Japanese man with a long occupational history of professional painter was sent to the emergency room, where he died of multiple organ failure. The patient had suffered tremors and inarticulateness at age 28, developed diabetes at 42 and was diagnosed with spinocerebellar degeneration at 46. A histopathological examination showed severe neuronal loss, gliosis, and tissue rarefaction in the paleostriatum, striate body of the substantia nigra, the pons, and the olivary nucleus of the upper medulla oblongata, intermediolateral of the spinal gray matter (sacral region). α-synuclein-positive GCI in oligodendroglia was occurred in the cerebral cortex, the midbrain, the medulla oblongata, and the spinal cord. These findings confirmed the presence of multiple-system atrophy (OPCA+SDS). Conclusion. Although the pathogenesis of MSA is still unclear, prolonged, and extensive exposure to organic solvents, together with a hyperglycemic morbidity attributed to diabetes, may have contributed to the onset and clinical course of the present case.http://dx.doi.org/10.1155/2012/613180
spellingShingle Yusa Nagai
Riko Kitazawa
Miku Nakagawa
Munenori Komoda
Takeshi Kondo
Ryuma Haraguchi
Sohei Kitazawa
Multiple-System Atrophy in Long-Term Professional Painter: A Case Report
Case Reports in Pathology
title Multiple-System Atrophy in Long-Term Professional Painter: A Case Report
title_full Multiple-System Atrophy in Long-Term Professional Painter: A Case Report
title_fullStr Multiple-System Atrophy in Long-Term Professional Painter: A Case Report
title_full_unstemmed Multiple-System Atrophy in Long-Term Professional Painter: A Case Report
title_short Multiple-System Atrophy in Long-Term Professional Painter: A Case Report
title_sort multiple system atrophy in long term professional painter a case report
url http://dx.doi.org/10.1155/2012/613180
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