Amin Adina, Crenesse-Cozien Natalia, Amardeep Kalsi, Sundaram Revathy
Internal Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, USA.
Neurology, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, USA.
Cureus. 2023 May 4;15(5):e38520. doi: 10.7759/cureus.38520. eCollection 2023 May.
Cord compression can arise from many different etiologies -- including trauma, degenerative changes, growths, neoplasms, or even abscesses. While some etiologies can cause symptoms such as weakness or motor deficits, others can simply present as pain. A rare cause of cord compression is extramedullary hematopoiesis (EMH), or the growth of blood cells outside the bone marrow. This rare, abnormal growth of cells can result in severe complications such as increased intracranial pressure and motor and sensory impairment. General clinicians should strive for early and prompt diagnosis of cord compression whenever possible, especially in patients who present with acute neurological deficits. We present a case of a 27-year-old female with beta thalassemia major (BTM) and transfusional hemosiderosis, who came in with progressive lower extremity weakness, numbness and urinary retention, and was diagnosed with acute cord compression from EMH.
脊髓受压可由多种不同病因引起,包括创伤、退行性变、肿物、肿瘤,甚至脓肿。虽然有些病因可导致诸如无力或运动功能障碍等症状,但其他病因可能仅表现为疼痛。脊髓受压的一种罕见病因是髓外造血(EMH),即骨髓外血细胞的生长。这种罕见的异常细胞生长可导致严重并发症,如颅内压升高以及运动和感觉障碍。普通临床医生应尽可能争取对脊髓受压进行早期和及时诊断,尤其是对于出现急性神经功能缺损的患者。我们报告一例27岁患有重型β地中海贫血(BTM)和输血性含铁血黄素沉着症的女性病例,该患者因进行性下肢无力、麻木和尿潴留前来就诊,被诊断为因EMH导致的急性脊髓受压。