UZUN SPİNAL KORD LEZYONU OLAN HASTADA BİYOPSİ İLE NÖROMİYELİTİS OPTİKA TANISI: OLGU SUNUMU

Year 2019, , 120 - 125, 30.04.2019

Ceyda Tanoğlu , Ruhsen Öcal , Münire Kılınç Toprak

https://doi.org/10.24938/kutfd.454182

Abstract

Nöromyelitis
Optika Spektrum Hastalıkları (NMOSH) tekrarlayan optik nörit ve longitudinal uzun
segment transvers miyelit atakları ile seyreden, Aquaporin-4 antikor pozitifliği
ile karakterize inflamatuar demiyelinizan bir hastalıktır. Uzun segment longitudinal
transvers miyelit, NMOSH dışında; sistemik otoimmun hastalıklarda, spinal kord tümörlerinde,
spinal vasküler patolojilerde de saptanabilmektedir. NMOSH, genç populasyonda ağır
disabiliteye neden olduğu için erken teşhis ve tedavi çok önemlidir. Bu sunumda,
akut parapleji ve idrar inkontinansı şikayeti ile polikliniğimize başvuran yirmi
üç yaşındaki kadın hasta tartışılmıştır. Spinal Manyetik Rezonans Görüntüleme’de
C7-T7 arasında kord içinde kontrast tutan longitudinal uzun
ödemli lezyon saptandı. Astrositom olarak raporlanması nedeniyle lezyondan biyopsi
yapıldı ve tümör düşünülmedi. NMOSH tanısı sonradan doğrulanan Aquaporin-4 pozitifliği
ile kesinleşti. Uzun segment spinal lezyonlar, NMOSH’da nadir olmasa da lezyonun
ödematöz ve beklenenden uzun olması nedeniyle bu olguyu sunmak istedik.

Keywords

nöromiyelitis optika, Aquaporin-4, transvers miyelit

The Diagnosis of Neuromyelitis Optica by Biopsy in a Patient with Long Spinal Cord Lesion: A Case Report

Abstract

Neuromyelitis
Optica Spectrum Diseases (NMOSD) is an inflammatory demyelinating disease, which
is characterized by recurrent optic neuritis, longitudinal long-segment transverse
myelitis attacks and Aquaporin-4 antibody positivity. Except NMOSD, long-segment
longitudinal transverse myelitis can be also detected in systemic autoimmune diseases,
spinal cord tumors, spinal vascular pathologies, Early detection and treatment of
NMOSD is very important as the disease may cause severe disability in young population.
A 23-year-old female patient was admitted to our clinic with acute paraplegia and
urine incontinence. Spinal Magnetic Resonance Imaging showed a densly edematose,
contrast enhanced lesion longitudinally extending between C7 and T7
in the spinal cord. As the lesion was reported to be an astrocytoma, a biopsy was
performed. However, pathological stainings revelaed no tumor. NMOSD was verified
later with Aquaporin-4 positivity. Although longitudinally extending spinal cord
lesions are not rare in NMOSD, our patient’s lesion was very edematose and longer
than expected that deserved reporting.

Keywords

Aquaporin-4, neuromyelitis optica, transverse myelitis

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