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Myelopathy in sickle cell disease: a case-oriented review.
Brum, Igor Vilela; Silva, Guilherme Diogo; Sodre, Diego Sant'Ana; Nogueira, Felipe Melo; Pereira, Samira Luisa Dos Apostolos; Castro, Luiz Henrique Martins.
Afiliação
  • Brum IV; Department of Neurology, University of São Paulo, São Paulo, Brazil. igor.brum@hc.fm.usp.br.
  • Silva GD; Department of Neurology, University of São Paulo, São Paulo, Brazil.
  • Sodre DS; Department of Neurology, University of São Paulo, São Paulo, Brazil.
  • Nogueira FM; Department of Hematology, University of São Paulo, São Paulo, Brazil.
  • Pereira SLDA; Department of Neurology, University of São Paulo, São Paulo, Brazil.
  • Castro LHM; Department of Neurology, University of São Paulo, São Paulo, Brazil.
Spinal Cord Ser Cases ; 7(1): 85, 2021 09 25.
Article em En | MEDLINE | ID: mdl-34564705
INTRODUCTION: Although neurological complications are well recognized in patients with sickle cell disease, myelopathy has been rarely described, with few reported cases of compressive and ischemic myelopathy. We present the first case report of longitudinally extensive myelitis (LETM) in SCD and review the differential diagnosis of myelopathy in these patients. CASE PRESENTATION: We report the case of a 29-year-old African-Brazilian man with SCD, who experienced a subacute flaccid paraparesis, with T2 sensory level and urinary retention. Cerebrospinal fluid analysis showed a lymphocytic pleocytosis and increased protein levels. MRI disclosed a longitudinally extensive spinal cord lesion, with a high T2/STIR signal extending from C2 to T12. We searched Medline/PubMed, Embase, Scopus, and Google Scholar databases for myelopathy in SCD patients. DISCUSSION: Spinal cord compression by vertebral fractures, extramedullary hematopoietic tissue, and Salmonella epidural abscess have been reported in SCD. We found only three case reports of spinal cord infarction, which is unexpectedly infrequent compared to the prevalence of cerebral infarction in SCD. We found only one case report of varicella-zoster myelitis and no previous report of LETM in SCD patients. Specific and time-sensitive causes of myelopathy should be considered in SCD patients. In addition to compression and ischemia, LETM is a possible mechanism of spinal cord involvement in SCD patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Compressão da Medula Espinal / Doenças da Medula Espinal / Anemia Falciforme / Mielite Tipo de estudo: Diagnostic_studies / Etiology_studies / Risk_factors_studies / Systematic_reviews Limite: Adult / Humans / Male Idioma: En Revista: Spinal Cord Ser Cases Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Compressão da Medula Espinal / Doenças da Medula Espinal / Anemia Falciforme / Mielite Tipo de estudo: Diagnostic_studies / Etiology_studies / Risk_factors_studies / Systematic_reviews Limite: Adult / Humans / Male Idioma: En Revista: Spinal Cord Ser Cases Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido