Characteristics of Atopic Myelitis and its Relationship With Toxocara
Canis Myelitis

J Korean Neurol Assoc > Volume 31(3); 2013 > Article

Journal of the Korean Neurological Association 2013;31(3): 158-164.

아토피척수염의 특징과 개회충척수염과의 연관성

이경재, 백인철 이주연 김성보 박상민 임중걸 이애영 손은희

충남대학교 의학전문대학원 충남대학교병원 신경과

Characteristics of Atopic Myelitis and its Relationship With Toxocara Canis Myelitis

Kyung Jae Lee

Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea

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. Key Words: Myelitis, Atopy, Toxocara, Recurrence