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新型冠状病毒肺炎相关横贯性脊髓炎:病例报告

COVID-19 associated transverse myelitis: case report.

作者信息

Tapia-Fonseca Claudia V, Cortés-Enríquez Omar D, Raya-Garza Laura P, Gutiérrez-Cuellar Diana M

机构信息

Department of Pediatrics, Hospital General de Zona con Medicina Familiar No. 6. Instituto Mexicano del Seguro Social, Monterrey, Mexico.

出版信息

Bol Med Hosp Infant Mex. 2024;81(3):191-194. doi: 10.24875/BMHIM.23000179.

Abstract

BACKGROUND

Transverse myelitis (TM) is a demyelinating inflammatory disease that presents with motor, sensory, and autonomic dysfunction, which may be acute or subacute. COVID-19-associated TM has been described in a scarce number of patients.

CLINICAL CASE

A 15-year-old previously healthy male patient with respiratory disease before his neurological deterioration presented to the emergency room after developing a complete medullary syndrome located at the cervical-dorsal level, with ascending and symmetric paraparesis that rapidly progressed to paraplegia, with sensory dysfunction from the T3 level, sphincter dysfunction and sudden ventilatory deterioration that required mechanical ventilation. Magnetic resonance imaging was compatible with acute TM. Inflammatory and non-inflammatory etiologies were discarded. In addition, a positive severe acute respiratory syndrome coronavirus 2 test was obtained. Treatment included steroid pulses and plasmapheresis, with an insidious evolution.

CONCLUSION

COVID-19 is an infrequent cause of TM and should be suspected when other etiologies have been ruled out.

摘要

背景

横贯性脊髓炎(TM)是一种脱髓鞘性炎症性疾病,表现为运动、感觉和自主神经功能障碍,可为急性或亚急性。与新型冠状病毒肺炎(COVID-19)相关的TM仅在少数患者中被描述过。

临床病例

一名15岁既往健康的男性患者,在出现神经功能恶化前有呼吸系统疾病,在出现位于颈胸段的完全性脊髓综合征后就诊于急诊室,表现为进行性对称性双下肢轻瘫并迅速发展为截瘫,T3水平以下感觉功能障碍、括约肌功能障碍以及突然出现的呼吸功能恶化,需要机械通气。磁共振成像与急性TM相符。排除了炎症性和非炎症性病因。此外,严重急性呼吸综合征冠状病毒2检测呈阳性。治疗包括使用类固醇冲击疗法和血浆置换,病情进展隐匿。

结论

COVID-19是TM的罕见病因,在排除其他病因时应怀疑该病。

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