Acute myelitis in a child: current hypotheses.
This report presents the case of a child with atopic dermatitis, who developed progressive muscular weakness and hypotonia of the four limbs. The cervical spinal cord magnetic resonance imaging revealed a C(4) lesion (T(2)-weighted images); the cerebrospinal fluid findings were normal. Treatment with intravenous immunoglobulins and methylprednisolone obtained rapid clinical improvement, and approximately 1 month later the small C(4) lesion disappeared. Various diagnostic hypotheses are discussed: acute myelitis by infective agents, acute disseminated encephalomyelitis, multiphasic disseminated encephalomyelitis, multiple sclerosis, and isolated postinfective myelitis. Another hypothesis relates to atopic myelitis, a form recently described in the Japanese literature, associated with atopic dermatitis, hyperIgEemia, and high levels of specific immunoglobulin E to Dermatophagoides farinae and Dermatophagoides pteronyssinus. This diagnosis is difficult to confirm without biopsy evidence of eosinophilic inflammation.
Taddeucci
Grazia
G
Department of Pediatrics, Section of Pediatric Neurology, University of Studies of Pisa, Italy. g.taddeucci@clp.med.unipi.it
Bonuccelli
Alice
A
Polacco
Paola
P
D000208:Acute Disease; D039741:Antigens, Dermatophagoides / Q000276:immunology; D002574:Cervical Vertebrae; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000150:complications; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D009187:Myelitis / Q000276:immunology* / Q000382:microbiology / Q000473:pathology*; D013116:Spinal Cord / Q000473:pathology
D039741:Antigens, Dermatophagoides; D007073:Immunoglobulin E