Shukla Avaneesh, Verma Shailendra Prasad, Verma Durga Prasad, Yadav Geeta
Clinical Hematology, King George's Medical University, Lucknow, India.
Clinical Hematology, King George's Medical University, Lucknow, India
BMJ Case Rep. 2020 Oct 30;13(10):e235754. doi: 10.1136/bcr-2020-235754.
A 21-year-old woman was admitted to the department of haematology with fever, generalised body ache and swelling of the feet. She also presented with band-like tightness over the abdomen and was unable to walk for the last 2 days. There was no history of trauma. She was diagnosed as a case of B-cell acute lymphoblastic leukaemia based on flow cytometry and bone marrow studies. MRI of the thoracolumbar spine revealed signal intensity alteration in the spinal cord from D1-2 to D5-6. Her serum vitamin B and folate levels were normal. Autoimmune workup including antinuclear antibody and viral serology, and reverse transcriptase PCR for herpes simplex virus, Epstein-Barr virus and cytomegalovirus were negative. Her cerebrospinal fluid was negative for malignant cells. She was started on Berlin-Frankfurt-Munster 95 protocol and her condition improved along with partial improvement in the power of her limbs at the time of discharge. The neurological diagnosis of non-compressive myelopathy due to myelitis was considered.
一名21岁女性因发热、全身酸痛和足部肿胀入住血液科。她还出现腹部束带状紧绷感，且在过去两天无法行走。无外伤史。根据流式细胞术和骨髓检查，她被诊断为B细胞急性淋巴细胞白血病。胸腰椎MRI显示脊髓从D1 - 2至D5 - 6信号强度改变。她的血清维生素B和叶酸水平正常。包括抗核抗体和病毒血清学在内的自身免疫检查，以及单纯疱疹病毒、EB病毒和巨细胞病毒的逆转录酶PCR均为阴性。她的脑脊液未发现恶性细胞。她开始接受柏林 - 法兰克福 - 明斯特95方案治疗，出院时病情好转，肢体力量也有部分改善。考虑为脊髓炎所致非压迫性脊髓病的神经学诊断。
