Atopic Myelitis : An Emerging Cause of Myelitis in Korea

BACKGROUND: HyperIgEemia and atopy has recently been reported to be related with various neurological diseases such as Hirayama disease and idiopathic myelitis. We aimed to determine frequency of atophy or hyperIgEemia in idiopathic myelitis in Korea and to characterize the clinic-laboratory and MRI profiles of atopic myelitis (AM) in comparison with non-AM. METHODS: From 2006 January to 2008 August, twenty nine consecutive patients with idiopathic myelitis (14 AM and 15 non-AM) were enrolled from registry. The frequency of hyperIgEemia and two mite antigen-specific IgE positivity was examined in idiopathic myelitis patients. In addition, we compared clinical data, laboratory results including neuromyelitis optica (NMO)-IgG, autoantibodies, and radiologic findings between AM and non-AM patients. RESULTS: Allergic or atopic history was found in only 4 patients (13%), but hyperIgEemia and mite antigen-specific IgE were observed in 17 (58%) and 19 (65%) of idiopathic myeltis patients, respectively. Patients with AM (n=14, 48%) showed following distinctive features. (1) younger age at onset (39 years vs. 51 years; p<0.0001), (2) non-acute onset (13/14 vs. 5/15; p=0.002) and long-duration of symptom at admission (76 days vs. 16 days; p<0.001), (3) predominant sensory symptom with mild weakness (4) low EDSS score (2.1 vs. 5.6; p<0.001), (5) low frequency of abnormal SEP findings (2/14 vs. 11/15; p<0.005), and (6) increased eosinophils in peripheral blood (5.0% vs. 1.0%; p<0.001). Common MR findings of AM included eccentric lesion occupying more than two thirds of spinal cord (92%) with focal peripheral enhancement (92%) on axial image, and the lesion usually extended more than 3 to 5 vertebral segments (71%) with cord swelling (71%). CONCLUSIONS: HyperIgEemia and mite antigen-specific IgE are fairly common in Korean idiopathic myelitis patients. The AM patients show relatively homogenous clinicolaboratory and radiological features. It is noteworthy that none of these patients shows brain abnormality suggestive of multiple sclerosis or neuromyelitis optica (NMO). These results suggest that AM is a distinct disease entity with different pathogenesis from multiple sclerosis or NMO.

Author dc:creator

• 윤, 정한

Contributors dc:contributor

• 주, 인수
• 대학원 의학과
• 105219

• Atopic myelitis
• Idiopathic myelitis
• Neuromyelitis optica
• Multiple sclerosis
• 아토피 척수염

Language dc:language

en

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000010086
000000010086

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/1449