ABSTRACT
Objective To investigate clinical characteristics and treatment of acute myelitis in children. Methods Clinical data and prognosis of two cases of pediatric acute myelitis with positive serum monosialoganglioside (GM1) antibodies were analyzed, and related literatures were reviewed. Results Two cases had clinical symptoms and MRI change of myelitis with positive serum GM1-IgM antibody and thyroid antibody. Two cases had positive serum Helicobacter pylori IgG antibody and one case has positive Mycoplasma pneumoniae IgM antibody.After treated with high doses of glucocorticoid and gamma-globulin, two cases were discharged as symptoms improved. After discharged, treatment with oral prednisone and rehabilitation were continued. One case recovered completely while another could stand alone by supporting after 3 months follow-up. Conclusion Immunologic injury played an important role in pathogenesis of acute pediatric myelitis with serum positive GM1 antibodies, which had better treatment outcome and prognosis. This type of myelitis may have intestinal Helicobacter pylori infection.
ABSTRACT
Guillain-Barre syndrme (GBS) has several subtypes that are divided by clinical, electro- physiological, and pathological findings. A novel form of GBS, that is termed acute motor axonal neuropathy (AMAN), is characterized by the selective involvement of motor fibers, and is associated with anti-GM1 antibodies. A 8-year-old male patient were developed ascending, symmetrical paralysis, and areflexia, but no sensory disturbance. Elevated titers of serum IgG anti-GM1 antibodies were detected. His thoracolumbar spine magnetic resonance imaging (MRI) revealed thickening of cauda equina and enhancement of anterior nerve roots of T12-L1 spinal level after Gd-DTPA infusion. Electrophysiological diagnosis was acute motor axonal neuropathy (AMAN). We report this case with review of the literature.