Darole Pramod, Sundar Uma, Kuchekar Nilesh, Karre Ajay
Department of Medicine, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India.
BMJ Case Rep. 2019 Mar 23;12(3):e227199. doi: 10.1136/bcr-2018-227199.
Acute transverse myelopathy in a young person may be due to infection, postinfective or inflammatory demyelination, or vascular causes. Rarely, a completely reversible cause of acute transverse myelopathy may be seen, as described here in our case of transverse myelopathy due to extramedullary haematopoiesis (EMH). An 18-year-old man who had a history of a lone blood transfusion at age of 7 years presented with paraplegia. MRI showed multiple epidural space masses of EMH compressing the spinal cord. He was detected to have thalassaemia intermedia and was treated with blood transfusions, steroids and radiotherapy to the involved paraspinal areas. He recovered fully over 15 days and remained symptom free at 6 months.
年轻人的急性横贯性脊髓病可能由感染、感染后或炎性脱髓鞘,或血管原因引起。极少数情况下,可能会出现急性横贯性脊髓病完全可逆的病因,如下文所述的我们这例因髓外造血(EMH)导致的横贯性脊髓病病例。一名18岁男性,7岁时曾有过一次输血史,现出现截瘫。MRI显示多个EMH硬膜外肿块压迫脊髓。他被诊断为中间型地中海贫血,并接受了输血、类固醇治疗以及对受累椎旁区域的放疗。他在15天内完全康复,6个月时仍无症状。