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Hemorrhagic Longitudinally Extensive Transverse Myelitis (LETM) as a First Presentation of Neuromyelitis Optica

Shima Jahani1, Fateme Jamshidi2, Abdorreza Naser Moghadasi1

  • 1Multiple Sclerosis Research Center, Neuroscience Institute Tehran University of Medical Sciences Tehran Iran.

Clinical Case Reports
|January 8, 2025
PubMed

Insights

A rare case of hemorrhagic longitudinally extensive transverse myelitis (LETM) presented as the first sign of Neuromyelitis Optica Spectrum Disorder. Despite aggressive treatment, the patient saw no improvement, highlighting diagnostic challenges and the need for prompt intervention.

Area of Science:

  • Neurology
  • Immunology
  • Pathology

Background:

  • Neuromyelitis Optica Spectrum Disorder (NMOSD) is a rare autoimmune disease targeting the central nervous system.
  • Longitudinally Extensive Transverse Myelitis (LETM) is a severe spinal cord inflammation, often a key feature in NMOSD.
  • Hemorrhagic myelitis, characterized by bleeding within the spinal cord, represents a particularly severe and challenging manifestation.

Purpose of the Study:

  • To report a rare case of hemorrhagic LETM as the initial presentation of NMOSD.
  • To emphasize the diagnostic difficulties associated with hemorrhagic LETM.
  • To underscore the critical need for timely and aggressive therapeutic interventions in such cases.

Main Methods:

  • Case report detailing a patient with initial symptoms of hemorrhagic LETM.
  • Review of diagnostic procedures and challenges encountered.
  • Analysis of treatment response and clinical outcome.

Main Results:

  • The patient presented with hemorrhagic LETM, later diagnosed as NMOSD.
  • Aggressive treatment did not lead to significant clinical improvement.
  • The case illustrates the complex diagnostic pathway for hemorrhagic LETM in NMOSD.

Conclusions:

  • Hemorrhagic LETM can be an initial manifestation of NMOSD.
  • Prompt diagnosis and intervention are crucial for managing hemorrhagic myelitis.
  • Diagnostic challenges in hemorrhagic LETM necessitate heightened clinical awareness.
Keywords:
NMOSDNeuromyelitis Optica Spectrum disorderhemorrhagic longitudinally extensive transverse myelitislongitudinally extensive transverse myelitishemorrhagic LETM

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