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Acute myelitis after asthma attacks with onset after puberty
I Horiuchi1, K Yamasaki, M Osoegawa
1Department of Neurology, Neurological Institute, Postgraduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
Journal of Neurology, Neurosurgery, and Psychiatry
|April 15, 2000
Summary
Asthmatic amyotrophy, a polio-like illness, can occur after asthma attacks in adults, not just children. This condition involves nerve damage and is linked to high IgE levels.
Area of Science:
- Neurology
- Immunology
- Pulmonology
Background:
- Asthmatic amyotrophy (Hopkins' syndrome) is a rare poliomyelitis-like illness previously reported only in children under 13.
- The condition links asthma exacerbations to acute neurological deficits.
Purpose of the Study:
- To describe cases of asthmatic amyotrophy occurring in patients over 13 years of age.
- To investigate the clinical spectrum and immunological features of adult-onset asthmatic amyotrophy.
Main Methods:
- Case series describing three patients (aged 15, 22, and 73) who developed myelitis after asthma attacks.
- Clinical examination, needle electromyography (EMG), and evoked potential studies were performed.
- Antiviral antibody titers, hyperimmunoglobulin E (hyperIgEaemia), and allergen-specific IgE levels were assessed.
Main Results:
- All patients presented with acute flaccid monoparesis, confirmed by EMG-detected denervation.
- Adult patients showed involvement of sensory or pyramidal tracts, with evoked potentials confirming pyramidal tract involvement in one.
- Patients had normal antiviral antibodies but elevated hyperIgEaemia and allergen-specific IgE.
Conclusions:
- Asthmatic amyotrophy can occur in individuals after puberty, including adults.
- Adult-onset cases may involve widespread spinal cord damage and exhibit a more variable clinical course.
- The condition is associated with hyperIgEaemia and allergen sensitization, suggesting an immune-mediated mechanism.