Khemiri M, Ouederni M, Barsaoui S
Service de Médecine Infantile A, Hôpital d'Enfants de Tunis, Tunis, Tunisie.
Med Mal Infect. 2007 Apr;37(4):237-9. doi: 10.1016/j.medmal.2006.12.010. Epub 2007 Mar 1.
Transverse myelitis is a rare manifestation of hepatitis A virus infection. We report the case of an eleven-year-old girl who presented a progressive flabby paraplegia with sphincter incontinence, superficial hypoesthesia, without deep involvement. Medullar MRI was suggestive of myelitis. Despite the absence of jaundice and hepatic cytolysis, the serology yielded a high rate of anti-hepatitis A immunoglobulin M. Neurological disorders disappeared within 15 days, after treating with a high dose of corticosteroids and physical rehabilitation. 24 months later she was asymptomatic. Screening for hepatitis A virus infection in patients with acute transverse myelitis should be indicated specially in endemic countries were vaccinal prophylaxis is not common practice.
横贯性脊髓炎是甲型肝炎病毒感染的一种罕见表现。我们报告一例11岁女孩,她出现进行性弛缓性截瘫,伴有括约肌失禁、浅感觉减退,无深部受累。脊髓磁共振成像提示为脊髓炎。尽管没有黄疸和肝细胞溶解,但血清学检测显示抗甲型肝炎免疫球蛋白M的阳性率很高。在大剂量使用皮质类固醇和进行物理康复治疗后,神经功能障碍在15天内消失。24个月后她无症状。在急性横贯性脊髓炎患者中进行甲型肝炎病毒感染筛查,在疫苗预防不普遍的流行国家尤其必要。