title: An Unusual Cause of Myelopathy: Ochronotic Spondyloarthropathy With Positive HLA B27.
abstract: Ochronosis is a late developing complication of alkaptonuria, a black brownish pigment in the fibrous and cartilaginous tissues. Although most previous studies reported alkaptonuria and back pain due to ochronosis, thoracic myelopathy is an extremely rare complication. In this report, a paraparetic patient who has ochronotic spondiloarthropathy with the presence of HLA B27 antigen is described. He had low back and leg pain and morning stiffness for 5 yrs. Last year, these were followed by tingling, numbness, and weakness the in lower extremities and he was operated on with preliminary diagnosis of prolapsed disc herniation and cord compression. Surgery is suggested for disc herniations related to ochronotic spondyloarthropathy if it is necessary or neurologic symptoms are present. However, his pain and weakness have partially recovered after the operation. After medical and physical treatment, he showed clinically significant improvements. This case report demonstrates that the management of ochronosis needs a multidisciplinary approach with physiologic, neurologic, and psychologic effects and proper treatment may significantly improve functional outcomes in these patients.
authors.affiliation: From the Atatürk Educational and Research Hospital, Physical Medicine and Rehabilitation Clinic (S. Bozkurt); and Physical Medicine and Rehabilitation Department (LA, FGU, NS, SA) and Pathology Department (S. Balci), Yildirim Beyazit University, Ankara, Turkey.
authors.forename: Sinem
authors.initials: S
authors.lastname: Bozkurt
authors.forename: Lale
authors.initials: L
authors.lastname: Aktekin
authors.forename: Fatma Gülçin
authors.initials: FG
authors.lastname: Uğurlu
authors.forename: Serdar
authors.initials: S
authors.lastname: Balci
authors.forename: Nebahat
authors.initials: N
authors.lastname: Sezer
authors.forename: Selami
authors.initials: S
authors.lastname: Akkus
mesh_terms: D015796:HLA-B27 Antigen / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009794:Ochronosis / Q000150:complications* / Q000276:immunology; D020335:Paraparesis / Q000150:complications / Q000276:immunology; D013118:Spinal Cord Diseases / Q000209:etiology* / Q000276:immunology; D025242:Spondylarthropathies / Q000150:complications* / Q000276:immunology; D013904:Thoracic Vertebrae
chemical_list: D015796:HLA-B27 Antigen