成人溃疡性结肠炎患者并发急性横贯性脊髓炎：病例报告。
Acute transverse myelitis in an adult-patient with underlying ulcerative colitis: a case report.
机构信息
Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, China.
出版信息
BMC Gastroenterol. 2022 Apr 1;22(1):161. doi: 10.1186/s12876-022-02230-z.
BACKGROUND
Ulcerative colitis (UC) is an idiopathic inflammatory bowel disease that limits to colon mucosa, which characterised by relapsing and remitting abdominal pain and diarrhea. Neurological complications in UC patients are usually underestimated. The most frequently reported neurological disorders associated with UC are peripheral neuropathy, cerebrovascular disease and demyelinating disease. However, acute transverse myelitis (TM) is rarely reported in UC patients.
CASE PRESENTATION
We report a case of a 39-year-old man presented with fatigue, muscle weakness, numbness in the lower limbs and fingers with underlying UC. Laboratory results revealed elevated neutrophil count, high-sensitivity C-reactive protein and erythrocyte sedimentation rate. Strip-shaped high signal intensity was identified in the cervical and thoracic spinal cord on T2-weighted magnetic resonance imaging. Acute TM was diagnosed. Significant improvements after intravenous high-dose methylprednisolone were observed.
CONCLUSION
We speculate that acute TM may be the extraintestinal manifestation of UC, which may be related to the abnormalities of cell-mediated and humoral immunity rather than the side effect of mesalazine.
背景
溃疡性结肠炎（UC）是一种特发性炎症性肠病，局限于结肠黏膜，其特征为反复发作的腹痛和腹泻。UC 患者的神经系统并发症通常被低估。与 UC 相关的最常报道的神经紊乱为周围神经病、脑血管病和脱髓鞘疾病。然而，UC 患者中很少报道急性横贯性脊髓炎（TM）。
病例介绍
我们报告了一例 39 岁男性，因潜在的 UC 出现疲劳、肌无力、下肢和手指麻木。实验室结果显示中性粒细胞计数、高敏 C 反应蛋白和红细胞沉降率升高。T2 加权磁共振成像显示颈胸段脊髓呈条带状高信号强度。诊断为急性 TM。静脉内大剂量甲基强的松龙治疗后观察到显著改善。
结论
我们推测急性 TM 可能是 UC 的肠外表现，可能与细胞介导和体液免疫异常有关，而不是美沙拉嗪的副作用。
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