Dolhun Rachel, Sriram S
Department of Neurology, Vanderbilt Medical Center, A-0118 Medical Center North 1161 21st Avenue South, Nashville, Tennessee 37212, USA.
J Clin Neurosci. 2009 Apr;16(4):595-7. doi: 10.1016/j.jocn.2008.06.004. Epub 2009 Feb 5.
Neurosarcoidosis is an uncommon clinical entity, even in patients with systemic sarcoidosis. Its presentation is widely varied but longitudinally extensive transverse myelitis secondary to neurosarcoidosis has only rarely been described. We report the case of a patient with pulmonary sarcoidosis and congenital immunosuppression who developed longitudinally extensive transverse myelitis secondary to neurosarcoidosis following splenectomy. Diagnosis was based on history, inflammatory changes on MRI, and cerebrospinal fluid findings. Standard therapy with intravenous steroids was unsuccessful. Only more novel treatment with Infliximab allowed improvement.
神经结节病是一种不常见的临床病症,即便在患有全身性结节病的患者中亦是如此。其表现形式多种多样,但继发于神经结节病的纵向广泛横贯性脊髓炎却鲜有报道。我们报告一例患有肺部结节病和先天性免疫抑制的患者,该患者在脾切除术后继发神经结节病并出现纵向广泛横贯性脊髓炎。诊断基于病史、磁共振成像(MRI)上的炎症变化以及脑脊液检查结果。静脉注射类固醇的标准治疗未取得成功。仅使用英夫利昔单抗这种更新颖的治疗方法才使病情有所改善。