Clinical and laboratory characteristics of atopic myelitis: Korean experience

Atopic myelitis: A case report from India

“…HyperIgEemia and mite antigen-specific IgE are fairly common [1,2]. These features were similar to those reported in 14 AM patients from Korea, although a few differences were noted, such as lower prevalence of a history of atopic diseases, thoracic cord preference, and higher frequencies of gadolinium-enhanced lesions compared with nationwide surveys in Japan [4]. The first diagnostic criteria for AM with special reference to discrimination from myelitis-onset multiple sclerosis (MS) have been proposed by Isobe et al which demonstrated 93.3% sensitivity and 93.3% specificity for AM against myelitis-onset MS, with 82.4% positive predictive value and 97.7% negative predictive value [5].…”

“…In a recent study of 14 patients with AM, none was found positive for anti-aquaporin 4 antibodies [4]. We did not test for the anti-aquaporin 4 antibody in our patient as she does not meet the current clinical diagnostic criteria for NMO and this antibody is rarely found in patients with short-segment cord lesions.…”

“…He did not have history of atopy in the forefront but when we retrospectively enquired him about any such history in the past, we found that he had allergic rhinitis during childhood but has not had any exacerbations of rhinitis in the past 15 years. Of interest, patients with hyperIgEemia and mitespecific antibody (IgE) in the absence of known history of atopy share common clinico-laboratory features with those with known atopy [2,4].…”

“…Most AM patients have been investigated in Japan [1,2], with very few cases of AM being reported elsewhere [3,4]. It has been unclear whether AM was as frequent in other Asian countries and whether it was a distinct entity, different from other idiopathic myelitis disorders.…”

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

“…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]. Such features were similar to those reported in 14 AM patients from Korea [6], although a few differences were noted, such as lower prevalence of a history of atopic diseases, thoracic cord preference, and higher frequencies of gadolinium-enhanced lesions compared with nationwide surveys in Japan. In addition, the nationwide surveys investigating AM and atopy-related peripheral neuritis, such as Churg-Strauss syndrome, have revealed that the clinical or laboratory data from approximately a quarter of AM patients indicated the simultaneous involvement of the peripheral nerves, which thus suggests an overlap with Churg-Strauss syndrome [5].…”