Neurology Department, Mayo Clinic, Rochester, MN, USA.
Neurology Department, Mayo Clinic, Rochester, MN, USA.
J Neuroimmunol. 2021 Dec 15;361:577750. doi: 10.1016/j.jneuroim.2021.577750. Epub 2021 Oct 13.
The differential diagnosis for immune-mediated myelopathies is broad. Although clinical manifestations overlap, certain presentations are suggestive of a particular myelopathy etiology. Spine MRI lesion characteristics including the length and location, and the pattern of gadolinium enhancement, help narrow the differential diagnosis and exclude an extrinsic compressive cause. The discovery of specific antibodies that serve as biomarkers of myelitis such as aquaporin-4-IgG and myelin-oligodendrocyte -glycoprotein-IgG (MOG-IgG), has improved our understanding of myelitis pathophysiology and facilitated diagnosis. In this review we will focus on the pathophysiology, clinical presentation, imaging findings and treatment and outcomes of uncommon immune-mediated myelopathies.
免疫介导性脊髓病的鉴别诊断范围很广。虽然临床表现有重叠，但某些表现提示特定的脊髓病病因。脊柱 MRI 病变特征包括长度和位置以及钆增强模式，有助于缩小鉴别诊断范围并排除外在压迫性原因。发现特定的抗体作为脊髓炎的生物标志物，如水通道蛋白 4-IgG 和髓鞘少突胶质细胞糖蛋白-IgG（MOG-IgG），提高了我们对脊髓炎病理生理学的理解并促进了诊断。在这篇综述中，我们将重点介绍罕见的免疫介导性脊髓病的病理生理学、临床表现、影像学发现以及治疗和结局。
