Non-compressive myelopathy: an unusual presentation of a patient with acute B lymphoblastic leukaemia

A 21-year-old woman was admitted to the department of haematology with fever, generalised body ache and swelling of the feet. She also presented with band-like tightness over the abdomen and was unable to walk for the last 2 days. There was no history of trauma. She was diagnosed as a case of B-cell acute lymphoblastic leukaemia based on flow cytometry and bone marrow studies. MRI of the thoracolumbar spine revealed signal intensity alteration in the spinal cord from D1-2 to D5-6. Her serum vitamin B₁₂ and folate levels were normal. Autoimmune workup including antinuclear antibody and viral serology, and reverse transcriptase PCR for herpes simplex virus, Epstein-Barr virus and cytomegalovirus were negative. Her cerebrospinal fluid was negative for malignant cells. She was started on Berlin-Frankfurt-Munster 95 protocol and her condition improved along with partial improvement in the power of her limbs at the time of discharge. The neurological diagnosis of non-compressive myelopathy due to myelitis was considered.