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Transverse myelitis in a child with Down's syndrome and schistosomal colitis
1Department of Paediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Insights
A child with Down's syndrome and Schistosoma mansoni colitis experienced transverse myelitis. Treatment with praziquantel led to significant recovery, allowing the child to walk again.
Area of Science:
- Medical Case Report
- Parasitology
- Neurology
Background:
- Down's syndrome can present with gastrointestinal issues.
- Schistosomiasis is a parasitic disease prevalent in certain regions.
Observation:
- An 11-year-old Saudi child with Down's syndrome presented with chronic diarrhea, anal fissures, and rectal bleeding, indicative of colitis.
- The child subsequently developed lower limb weakness, leading to inability to walk, suggesting spinal cord involvement.
Findings:
- The child was diagnosed with Schistosoma mansoni colitis complicated by transverse myelitis due to spinal cord involvement.
- Two courses of praziquantel therapy were administered over 1-day periods.
Implications:
- This case highlights the potential for Schistosoma mansoni to cause neurological complications like transverse myelitis, even in individuals with Down's syndrome.
- Prompt diagnosis and treatment with praziquantel can lead to favorable neurological recovery and improved mobility.
Abstract:
This is a report of an 11-year-old Saudi child with Down's syndrome who presented with a 3-month history of diarrhoea, anal fissures and bleeding per rectum. The child was investigated in a local hospital and found to have evidence of colitis. He was referred to our hospital for further investigation and management. Six weeks prior to transfer, the child developed weakness of the lower limbs resulting in inability to walk. The child was found to have Schistosoma mansoni colitis complicated by spinal cord involvement presenting as transverse myelitis. Two 1-day courses of therapy with praziquantel resulted in a satisfactory recovery, enabling the child to walk by himself.