An analysis of clinical and imaging characteristics of atopic myelitis / 中华内科杂志

Objective To study the clinical and imaging characteristics of Chinese atopic myelitis (AM) patients.Methods Three diagnosed AM patients were retrospectively analyzed for the clinical data,serum IgE level,antigen specific IgE,cerebrospinal fluid,spinal MRI and therapeutic efficacy profiles.Results All the three patients were male and presented as subacute AM with the onset at 25,47 and 49 years old respectively.Two patients were allergic to pollen and other drugs,while another patient suffered from allergic rhinitis.Elevated serum total IgE and mite antigen specific IgE were found in all cases.Paraesthesia in limb extremities and positive Lhermitte sign were the main clinical features,while no optic,motor,urinary and defecation disturbance were found.Oligoclonal banding of cerebrospinal fluid and serum aquaporin 4 (AQP4) antibody were both negative in all cases.Spinal MRI showed lesions were hypointense on T1 and hyperintense on T2 at the posterior column of T2-3 segment with abnormal enhancement in case 1,hypointense on T1 and hyperintense on T2 at C2/3 segment with mild swelling in case 2 and hypointense on T1 and hyperintense on T2 at C3-5 segments with swelling and abnormal enhancement in case 3.Vitamin B were used in one patient,while the other two patients improved after the treatment with high-dose corticosteroids.Conclusions Subacute myelitis predominantly presents as paraesthesia in limb extremities with elevated serum total IgE and mite antigen specific IgE,while severe motor disorders are rare.Swelling and abnormal enhancement lesions at the posterior column of cervical cord are the common imaging features.Treatment with corticosteroids is recommended to be sustained for 3-6 months.

Two Cases of Atopic Myelitis

Myelitis is caused by various infectious organisms or an autoimmune mechanism. We report two cases of myelitis with increased serum total IgE and mite antigen specific IgE. The patients had paresthesia and Lhermitte's signs without weakness nor bladder dysfunctions. A spine MRI revealed a T2-high signal lesion with focal enhancement in the upper cervical cord. The patients showed favorable responses to steroid treatment. Atopic myelitis should be considered as a form of myelitis.

The Relation of Food-Specific IgE to Recurrent Wheezing Attack

PURPOSE: There were some reports that IgE-mediated food hypersensitivity is associated with subsequent development of atopic disease in wheezy infants. So we carried out this study to show whether the food specific IgE antibodies are useful to predict recurrent wheezing attack in wheezy infants. METHODS: A total of 190 children younger than 4-year-old were enrolled in this study. They were divided into 3 groups according to the number of experienced wheezing attacks as 1st, 2nd and more than 3rd attack group. There were 30 age-matched controls who had not wheezing nor family members of allergy. We measured peripheral blood eosinophil count, total serum IgE level, RAST f1(egg white), f2(milk), D1(Dp) and D2(Df) from the all participants. RESULTS: The proportion of patients having more than 250/mm3 cosinophils in each group increased as increasing wheezing attacks(P0.05). There was no significant difference in RAST f1 levels among the four groups. In contrast, the proportion of positive RAST f1 increased significantly as the number of wheezing attacks increased(P0.05). CONCLUSION: Egg white specific IgE antibody appear to be a risk factor for recurrent wheezing in infants and young child.