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Intramedullary lesion resection as an effective treatment of spinal cord microscopic polyangiitis: a case report
Zhiqian Yang1,2,3, Dongpeng Cai1,2, Yesheng Sun1,2
1Department of Neurosurgery, First Affiliated Hospital of Guangdong Pharmaceutics University, No. 19 Nonglinxia Road, Guangzhou, 510080, China.
Background:
Microscopic polyangiitis (MPA), an autoimmune disease, is a subtype of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis. The lungs and kidneys are the most common targets, whereas spinal cord involvement is rare.
Methods:
We reported the clinical manifestations, diagnosis, and management of a patient with spinal cord MPA.
Results:
The patient showed spinal compression symptoms and was diagnosed with MPA following magnetic resonance imaging (MRI) and histological examination. Spinal compression symptoms were completely relieved after intramedullary lesion resection and postoperative treatment with methylprednisolone.
Conclusion:
The diagnosis of MPA without typical manifestations can be challenging. MRI and histological examination are of great importance in spinal cord MPA diagnosis. Intramedullary lesion resection is an effective treatment for spinal cord MPA. Methylprednisolone is also recommended for postoperative treatment.
Insights
Spinal cord microscopic polyangiitis (MPA) is rare but treatable. Prompt diagnosis with MRI and histology, followed by surgery and methylprednisolone, effectively relieved symptoms in a patient with spinal cord MPA.
Area of Science:
- Neurology
- Rheumatology
- Immunology
Background:
- Microscopic polyangiitis (MPA) is a rare autoimmune subtype of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis.
- While MPA commonly affects lungs and kidneys, spinal cord involvement is exceptionally rare.
Observation:
- A patient presented with symptoms indicative of spinal cord compression.
- Diagnosis was confirmed via magnetic resonance imaging (MRI) and histological examination, revealing MPA.
Findings:
- Surgical resection of the intramedullary lesion provided complete relief from spinal compression symptoms.
- Postoperative treatment with methylprednisolone was administered.
Implications:
- This case highlights the diagnostic challenges of MPA presenting without typical systemic manifestations.
- MRI and histology are crucial for diagnosing spinal cord MPA.
- Intramedullary lesion resection and methylprednisolone are effective therapeutic strategies for spinal cord MPA.
