Atopic myelitis: A clinical, biological, radiological and histopathological diagnosis

First diagnostic criteria for atopic myelitis with special reference to discrimination from myelitis-onset multiple sclerosis

“…Since we reported the first cases in 1996 [1], similar clinical and even pathologically confirmed cases [2,3] have been reported from other facilities, mainly in Japan with some from Korea and European countries, and its demographic features have gradually been clarified. Repeated nationwide surveys of AM in Japan have revealed that patients with AM most commonly show cervical cord involvement, mainly in the posterior column, preferentially demonstrating sensory impairment in the four limbs, while motor weakness and muscle atrophy were more frequently seen in those with bronchial asthma than in those with other atopic disorders [4,5].…”

“…On the one hand, increasing numbers of AM cases have been reported outside Japan [2,3,6,8], while on the other hand, there is a need for early introduction of disease-modifying drugs for MS or even clinically isolated syndrome. Therefore, demand for more evidence-based criteria for AM is growing, to ensure the correct differentiation of AM from myelitis-onset MS as early as possible.…”

Clinical and laboratory characteristics of atopic myelitis: Korean experience

“…Recent clinicopathological findings have revealed active eosinophil infiltration with the deposition of eosinophil cationic protein, despite mild and long duration of symptoms [9,20]. Furthermore, axons as well as myelin were severely destroyed [20].…”

“…Most AM patients have been investigated in Japan, with very few cases of AM being reported in western countries [8,9]. It has been unclear whether AM was as frequent in other Asian countries as in the case of Hirayama disease and whether it was a distinct entity, different from other idiopathic myelitis disorders, multiple sclerosis or neuromyelitis optica (NMO).…”

Acute inflammatory myelopathies

“…Although initially described in Japan, cases of atopic myelitis have been described in European patients (Zoli et al, 2005;Gregoire et al, 2006). Interestingly, several patients with atopic myelitis have developed focal amyotrophy, suggesting a potential link between atopic myelitis and Hopkin's syndrome, a rare poliomyelitis-like illness associated with acute asthma in children (Hopkins, 1974;Kira et al, 2008).…”