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[A case of atopic myelitis]
H Horinouchi1, J Inobe, T Mori
1Third Department of Internal Medicine, Oita Medical University.
Rinsho Shinkeigaku = Clinical Neurology
|July 8, 2000
Summary
This case study presents a rare instance of atopic myelitis in a woman with severe hyper IgE syndrome, anorexia nervosa, and primary hyperparathyroidism. The findings highlight a potential link between these complex conditions and myelopathy.
Area of Science:
- Neurology
- Immunology
- Endocrinology
Background:
- Atopic myelitis is a recently described condition characterized by myelopathy associated with hyperimmunoglobulin E (hyperIgE) syndrome and atopic dermatitis.
- This case explores the neurological manifestations in a patient with co-occurring anorexia nervosa and primary hyperparathyroidism.
Observation:
- A 35-year-old woman presented with a 10-month history of progressive numbness in the lower trunk and legs, accompanied by atopic dermatitis.
- Neurological examination revealed Lhermitte's sign, hand muscle weakness, sensory deficits below the Th4 level, and hyperreflexia.
- Laboratory findings included hyperIgEemia, elevated mite-specific IgE, hypercalcemia, and parathyroid gland swelling, leading to a diagnosis of primary hyperparathyroidism.
Findings:
- Cervical MRI showed abnormal signal intensity in the C6-C7 spinal cord segments.
- The patient's constellation of symptoms and laboratory results supported a diagnosis of atopic myelitis.
- Co-existing anorexia nervosa and primary hyperparathyroidism were noted as significant comorbidities.
Implications:
- This case expands the clinical spectrum of atopic myelitis, suggesting it can present with complex comorbidities.
- It underscores the importance of considering myelopathy in patients with hyperIgE syndrome and atopic dermatitis.
- Further research is warranted to elucidate the pathophysiological mechanisms linking these conditions.