Caracterización de la mielitis transversa en un hospital referencia del sur colombiano / Characterization of patients with transverse myelitis in a referral hospital in southern Colombia

RESUMEN

Objetivo: caracterizar a los pacientes con diagnóstico de mielitis transversa (MT) en un hospital de referencia del sur de Colombia durante los años 2007 a 2013. Materiales y métodos: Estudio transversal. Se incluyeron todos los pacientes con diagnóstico de MT, según los criterios The Transverse Myelitis Consortium Working Group. Resultados: En total 21 casos de MT (1,3 casos/10 000 ingresos), el 66,7% en edades entre 15-30 años, 57,1% de género femenino; 81,0% agudos. Todos presentaron déficit motor, 52,4% disfunción vesical autonómica, 81,0% nivel sensitivo. Se documentaron hallazgos imagenológicos de MT en resonancia magnética nuclear en el 71,4% de los casos e hiperproteinorraquia en 50%. En el 66,7% la etiología fue desconocida, en los casos en quienes se logró determinar la etiología fue: herpes simple tipo 1 (9,5%), varicela zoster (9,5%), leucemia mieloide aguda (4,8%), lupus eritematoso sistémico (4,8%) y deficiencia de vitamina B12 (4,8%). Conclusiones: La MT es un importante problema de salud pública, es necesario considerar sus características clínicas, establecer las formas idiopáticas y reconocer etiologías infecciosas dado el impacto terapeutico y pronóstico

ABSTRACT

Objective: To characterize patients with a diagnosis of transverse myelitis (TM) in a referral hospital in southern Colombia during years 2007 to 2013. Material and methods: This is a crosssectional study. All patients with a TM diagnosis were included, according to the criteria set by the Transverse Myelitis Consortium Working Group. Results: We had a total number of 21 cases of TM (1.3 cases/10,000 admissions). Two thirds (66,7%) of all patients were between 15-30 years of age, 57,1% were female; 81.0% had an acute presentation, 100% had motor deficit, 52.4% had autonomic bladder dysfunction, and 81.0% had sensitive level. MT findings were documented using magnetic resonance imaging in 71.4% of cases and 50% by high protein levels in the cerebrospinal fluid. Two thirds (66.7%) of the cases had an unknown etiology. In those cases in which their origin could be identified, the etiologies were: Type I Herpes Simplex (9.5%); Varicella Zoster (9.5%), acute myeloid leukemia (4.8%), systemic lupus erythematosus (4.8%) and vitamin B12 deficiency. Conclusion: MT is a major public health problem, and it is necessary to consider its clinical features, to establish its idiopathic forms and to recognize its infectious causes given their therapy impact and prognosis