Characteristics of Atopic Myelitis and its Relationship With Toxocara Canis Myelitis

ABSTRACT

BACKGROUND: It has recently been reported that atopic disorders are associated with various neurological diseases. Atopic myelitis (AM) has been defined as an idiopathic myelitis with either (1) an atopic disease such as atopic dermatitis, allergic rhinitis, or bronchial asthma, or (2) positive mite antigen-specific immunoglobulin E (IgE) with hyper-IgE-emia. The aim of this study was to characterize the clinical, radiological, and laboratory profiles of AM. METHODS: The characteristics of a group of patients with AM (n=18) were compared with those of a group of non-AM subjects (n=13). The history, clinical symptoms, serologic and cerebrospinal fluid (CSF) findings, and brain and spinal-cord magnetic resonance imaging (MRI) scans of all of the subjects were reviewed. RESULTS: Clinically, nonacute onset occurred more frequently in the AM group than in the non-AM group (72.2% vs. 30.8%, p=0.033). The positivity of specific IgG antibody to Toxocara canis was greater in the AM group than in the non-AM group (p=0.045). Swelling (p=0.001) and gadolinium enhancement (p=0.014) on MRI was also more prevalent in the AM group. There was tendency toward a greater proportion of males, purely sensory symptoms, a higher recurrence rate, and eosinophilia in the AM group than in the non-AM group. CONCLUSIONS: These findings suggest that AM is responsible for a considerable proportion of cases with idiopathic myelitis. It appears that the progression of symptom onset is slower, the positivity of specific IgG antibody to Toxocara canis higher, and the occurrence of swelling and enhancement of the lesion on spinal-cord MRI is more prevalent among those with AM than those without.