PMID- 20127351
OWN - NLM
STAT- MEDLINE
DCOM- 20100929
LR  - 20211020
IS  - 1432-1459 (Electronic)
IS  - 0340-5354 (Linking)
VI  - 257
IP  - 6
DP  - 2010 Jun
TI  - The clinical course of idiopathic acute transverse myelitis in patients from Rio 
      de Janeiro.
PG  - 992-8
LID - 10.1007/s00415-009-5450-6 [doi]
AB  - The aim of this study was to describe the demographic, clinical and laboratory 
      features of idiopathic acute transverse myelitis (IATM). Patients with 
      non-compressive ATM receiving care at Hospital da Lagoa, Rio de Janeiro (Brazil) 
      between 2000 and 2008 were selected. Of the 70 cases of acute myelopathies, the 
      idiopathic form was identified in 41 following exclusion of the cases associated 
      with systemic lupus erythematosus (n = 1), Sjogren's syndrome (n = 1), herpes 
      zoster (n = 1), cytomegalovirus in an HIV-positive patient (n = 1), Schistosoma 
      mansoni (n = 1), actinic myelitis (n = 1), infectious myelitis of unknown 
      etiology (n = 2) and those that, following the first attack of myelitis, 
      converted to NMO (n = 19) or to clinically defined MS (n = 2). Of the 41 cases of 
      IATM, the majority of patients were female (68.3%) and white (65.9%). Median age 
      at first myelitis was 37.0 +/- 11.8 years. Over a median observation time of 36 
      months, 39.0% of patients remained monophasic, while recurrences occurred in 
      61.0% of cases. The number of ATM/patient ranged from one to seven. Among the 
      recurrent cases the median time between the first and the second ATM was 12 
      months (range 1-150 months).The first myelitis was characterized mainly by 
      partial myelitis with motor and sensorial dysfunction (63.4%). Complete and 
      severe myelitis occurred more frequently among monophasic patients and partial 
      myelitis with moderate dysfunction at onset in recurrent cases; however, over the 
      long-term, dysfunction and disability were mild in both groups. Serial spine MRI 
      confirmed spinal cord inflammation in 92.0% of cases and extensive spinal cord 
      lesion was identified in 61.0%. Brain MRI was normal or not suggestive of MS in 
      94.4% of cases. CSF showed pleocytosis in 41.2%, increased IgG index in 24.0% and 
      oligoclonal bands in 38.0% of 34 patients tested. Abnormal visual evoked 
      potentials occurred in 11.5% of 26 patients. Positivity for anti-AQP4 was found 
      in 23.5% of the 17 cases tested, suggesting limited forms of NMO. This study 
      suggests some new aspects of the clinical course of IATM such as the high 
      conversion rate to NMO, the predominance of women and a higher frequency of 
      recurrent forms.
FAU - Alvarenga, Marina Papais
AU  - Alvarenga MP
AD  - Departamento de Neurologia, Universidade Federal do Estado do Rio de Janeiro, Rua 
      Mariz e Barros 775, Tijuca, Rio de Janeiro 20270-004, Brazil. 
      alvarenga_marina@hotmail.com
FAU - Thuler, Luiz Claudio Santos
AU  - Thuler LC
FAU - Neto, Silvio Pecanha
AU  - Neto SP
FAU - Vasconcelos, Claudia Cristina Ferreira
AU  - Vasconcelos CC
FAU - Camargo, Solange Gomes
AU  - Camargo SG
FAU - Alvarenga, Marcos Papais
AU  - Alvarenga MP
FAU - Papais-Alvarenga, Regina Maria
AU  - Papais-Alvarenga RM
LA  - eng
PT  - Journal Article
DEP - 20100203
PL  - Germany
TA  - J Neurol
JT  - Journal of neurology
JID - 0423161
RN  - 0 (AQP4 protein, human)
RN  - 0 (Aquaporin 4)
RN  - 0 (Autoantibodies)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aquaporin 4/immunology
MH  - Autoantibodies/metabolism
MH  - Brain/pathology/physiopathology
MH  - Brazil
MH  - Child
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Myelitis, Transverse/pathology/*physiopathology
MH  - Neuromyelitis Optica/pathology/physiopathology
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Spinal Cord/pathology/physiopathology
MH  - Young Adult
EDAT- 2010/02/04 06:00
MHDA- 2010/09/30 06:00
CRDT- 2010/02/04 06:00
PHST- 2009/08/05 00:00 [received]
PHST- 2009/12/30 00:00 [accepted]
PHST- 2009/12/28 00:00 [revised]
PHST- 2010/02/04 06:00 [entrez]
PHST- 2010/02/04 06:00 [pubmed]
PHST- 2010/09/30 06:00 [medline]
AID - 10.1007/s00415-009-5450-6 [doi]
PST - ppublish
SO  - J Neurol. 2010 Jun;257(6):992-8. doi: 10.1007/s00415-009-5450-6. Epub 2010 Feb 3.