Transverse myelitis associated with Crohn's disease: an exceptional case, idiopathic or secondary?

Area of Science:

• Neurology
• Immunology
• Pathology

Background:

• Transverse myelitis (TM) is a rare, severe inflammatory condition impacting the spinal cord.
• It manifests with significant sensory, motor, and autonomic nervous system dysfunction.
• The annual incidence rate ranges from 1 to 5 cases per million individuals.

Purpose of the Study:

• To outline the classification and potential etiologies of transverse myelitis.
• To provide an overview of the clinical presentation and diagnostic considerations for TM.
• To highlight the diverse range of conditions associated with this spinal cord disorder.

Main Methods:

• Literature review of transverse myelitis etiological factors.
• Analysis of classification criteria for TM subtypes.
• Summary of clinical manifestations and diagnostic workup.

Main Results:

• Exclusion of metabolic, vascular, and demyelinating diseases is crucial for TM diagnosis.
• Identified causes include paraneoplastic, parainfectious, toxic-pharmacological (e.g., TNFα inhibitors), and systemic diseases (e.g., Lupus).
• Idiopathic cases account for up to 30% of all transverse myelitis diagnoses after comprehensive evaluation.

Conclusions:

• Transverse myelitis presents a complex diagnostic challenge with varied underlying causes.
• Prompt identification and classification are essential for appropriate patient management.
• Further research into idiopathic TM is warranted to elucidate underlying mechanisms.