Caldas C, Bernicker E, Nogare A D, Luby J P
Department of Internal Medicine, Southwestern Medical School, Dallas, Texas 75235-8859.
Am J Med Sci. 1994 Jan;307(1):45-8. doi: 10.1097/00000441-199401000-00009.
Transverse myelitis is a rare complication of Epstein-Barr virus (EBV) infection. This article describes a case of a previously healthy patient with a subacute transverse myelopathy. The cerebrospinal fluid showed lymphocytic pleocytosis and protein elevation. A magnetic resonance imaging scan demonstrated abnormal spinal cord signal intensity over several cervical and thoracic segments, suggesting the diagnosis of transverse myelitis. The patient was treated with high-dose corticosteroids and had a rapid improvement. Serologic studies for other viruses were negative; antibody tests indicated acute EBV infection. It is thought this represents a case of transverse myelitis associated with acute EBV infection. Although a few similar patients have been reported previously, this case is the first where EBV serology suggested the etiology at the time of diagnosis, when EBV antibody titers and polymerase-chain reaction for EBV DNA in the cerebrospinal fluid were performed, and when a magnetic resonance imaging scan was used for diagnosis and follow-up.
横贯性脊髓炎是一种罕见的爱泼斯坦-巴尔病毒（EBV）感染并发症。本文描述了一例既往健康的患者发生亚急性横贯性脊髓病的病例。脑脊液显示淋巴细胞增多和蛋白升高。磁共振成像扫描显示多个颈段和胸段脊髓信号强度异常，提示横贯性脊髓炎的诊断。该患者接受了大剂量皮质类固醇治疗，病情迅速改善。针对其他病毒的血清学研究为阴性；抗体检测表明为急性EBV感染。据认为，这代表了一例与急性EBV感染相关的横贯性脊髓炎病例。尽管此前已报告了一些类似患者，但该病例是首例在诊断时通过EBV血清学提示病因、进行EBV抗体滴度检测以及脑脊液中EBV DNA的聚合酶链反应检测且使用磁共振成像扫描进行诊断和随访的病例。
