Longitudinally extensive transverse myelitis with pulmonary tuberculosis: Two case reports.

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• Longitudinally extensive transverse myelitis (LETM) involves spinal cord inflammation across at least three vertebral segments.
• While often idiopathic, LETM can stem from infections or autoimmune conditions.
• Neuromyelitis Optic Spectrum Disorder (NMOSD) is a frequent cause of LETM, with reported associations with pulmonary tuberculosis (PTB).

Observation:

• Two patients with LETM and a history of PTB were studied.
• Patient 1, anti-aquaporin-4 antibody (AQP4-Ab) positive NMOSD, presented with limb weakness and sensory deficits.
• Patient 2, anti-AQP4-Ab negative LETM, experienced lower limb and chest numbness.

Findings:

• Both patients received a combination of corticosteroids and anti-tuberculosis drugs.
• Follow-up up to one year demonstrated reduced spinal cord lesion size.
• Both patients showed improvement in their Expanded Disability Status Scale (EDSS) scores.

Implications:

• Combined corticosteroid and anti-tuberculosis treatment may improve outcomes for LETM patients with PTB.
• This therapeutic strategy could offer a better prognosis in managing co-occurring LETM and PTB.
• Further research is warranted to confirm these findings in larger cohorts.