PMID- 34041124
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210528
IS  - 2249-4863 (Print)
IS  - 2278-7135 (Electronic)
IS  - 2249-4863 (Linking)
VI  - 10
IP  - 2
DP  - 2021 Feb
TI  - Tubercular longitudinally extensive transverse myelitis (LETM): An enigma for 
      primary care physicians.
PG  - 1057-1060
LID - 10.4103/jfmpc.jfmpc_2101_20 [doi]
AB  - Albeit, all forms of tuberculosis (TB) are endemic in India, spinal 
      intramedullary TB and tubercular longitudinally extensive transverse myelitis 
      (LETM) is deemed extremely rare. With recent advances in the field of neurology, 
      autoimmune astrocytopathy (neuromyelitis optica spectrum disorders, NMOSD), 
      myelin-oligodendrocyte glycoprotein associated encephalomyelitis (MOG-EM), 
      metabolic myelopathy, connective tissue diseases and viral infections have gained 
      considerable focus in the list of differentials of LETM whereas tubercular 
      association is often forgotten. This report presents a rare case of acute 
      transverse myelopathy which unveiled previously undiagnosed pulmonary 
      tuberculosis in an adult rural Indian male. The patient responded well to 
      anti-tubercular therapy and corticosteroids. Exact pathogenesis of LETM in TB 
      remains elusive. Association of TB with MOG-EM has been one of the recent 
      hot-cakes. However, an ill-defined immune-inflammatory response to the infectious 
      agent is the likely cause of tubercular LETM. Hence, the primary care physicians 
      who are the first medical contacts of acute LETM cases and in most cases due to 
      diagnostic dilemma there is an unavoidable delay in accurate diagnosis and 
      initiation of therapy. Primary care doctors should nurture a high index of 
      suspicion to diagnose this potentially lifetime-debilitating yet absolutely 
      treatable clinical condition i.e. tubercular LETM.
CI  - Copyright: (c) 2021 Journal of Family Medicine and Primary Care.
FAU - Anand, Kumar Abhishek
AU  - Anand KA
AD  - Resident, Department of General Medicine, Burdwan Medical College and Hospital, 
      Burdwan, West Bengal, India.
FAU - Bhowmik, Kalyan Kumar
AU  - Bhowmik KK
AD  - Resident, Department of General Medicine, Burdwan Medical College and Hospital, 
      Burdwan, West Bengal, India.
FAU - Sarkar, Amit
AU  - Sarkar A
AD  - Assistant Professor, Department of General Medicine, Burdwan Medical College and 
      Hospital, Burdwan, West Bengal, India.
FAU - Ghosh, Ritwik
AU  - Ghosh R
AD  - Resident, Department of General Medicine, Burdwan Medical College and Hospital, 
      Burdwan, West Bengal, India.
FAU - Mandal, Arpan
AU  - Mandal A
AD  - Associate Professor, Department of General Medicine, Burdwan Medical College and 
      Hospital, Burdwan, West Bengal, India.
FAU - Swaika, Bikash
AU  - Swaika B
AD  - Professor and Head of the Department, Department of General Medicine, Burdwan 
      Medical College and Hospital, Burdwan, West Bengal, India.
FAU - Ray, Biman Kanti
AU  - Ray BK
AD  - Professor, Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), 
      Kolkata, West Bengal, India.
LA  - eng
PT  - Case Reports
DEP - 20210227
PL  - India
TA  - J Family Med Prim Care
JT  - Journal of family medicine and primary care
JID - 101610082
PMC - PMC8138341
OTO - NOTNLM
OT  - Longitudinally extensive transverse myelitis
OT  - myelopathy
OT  - tuberculosis
COIS- There are no conflicts of interest.
EDAT- 2021/05/28 06:00
MHDA- 2021/05/28 06:01
PMCR- 2021/02/01
CRDT- 2021/05/27 06:48
PHST- 2020/10/11 00:00 [received]
PHST- 2020/12/02 00:00 [revised]
PHST- 2021/01/05 00:00 [accepted]
PHST- 2021/05/27 06:48 [entrez]
PHST- 2021/05/28 06:00 [pubmed]
PHST- 2021/05/28 06:01 [medline]
PHST- 2021/02/01 00:00 [pmc-release]
AID - JFMPC-10-1057 [pii]
AID - 10.4103/jfmpc.jfmpc_2101_20 [doi]
PST - ppublish
SO  - J Family Med Prim Care. 2021 Feb;10(2):1057-1060. doi: 
      10.4103/jfmpc.jfmpc_2101_20. Epub 2021 Feb 27.