结核纵向广泛横侧肌炎:2例病例和文献综述
Si Tian1, Nannan Dong1, Mengru Li1
1Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
The journal of spinal cord medicine
|January 13, 2025
概括
结核纵向扩散横侧髓炎 (TB-LETM) 是一种罕见的结核病并发症. 诊断包括脑脊液分析,MRI和T-SPOT.TB测试,治疗结合抗结核病药物和皮质类固醇.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 放射学 放射学是一门学科.
背景情况:
- 结核病 (TB) 可以表现为一种罕见的神经疾病,称为结核纵向扩散横向髓炎 (TB-LETM).
- 结核病-LETM由于其稀有性和与自身免疫性疾病的潜在重叠而提出了诊断挑战.
研究的目的:
- 研究结核病的特征,诊断和管理.
- 在现有文献的背景下分析TB-LETM病例的临床和成像发现.
主要方法:
- 对两名TB-LETM患者的病例分析.
- 对临床表现的审查,脊柱磁共振成像 (MRI) 发现,脑脊液 (CSF) 分析和T-SPOT.TB测试结果.
- 与之前报告的14例TB-LETM病例进行比较.
主要成果:
- 两名女性患者出现了严重的神经缺陷 (四肢,下肢虚弱/麻木) 和尿路功能障碍.
- 核磁共振扫描显示,在一个患者身上,脊髓病变 (C1-T3和T1-T4) 严重,脑内内增强.
- 增加的CSF细胞数和蛋白质,阳性T-SPOT.TB,但发现了结核病的负微生物证据.
结论:
- 纵向扩展的横侧髓炎 (LETM),特别是在宫和胸部区域,应该引起人们对结核感染的怀疑.
- 诊断工具包括CSF分析,MRI和T-SPOT测试.
- 结合抗结核治疗和皮质类固醇是TB-LETM的有效管理策略.
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