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J Neurol Neurosurg Psychiatry 82:1022-1024 doi:10.1136/jnnp.2009.186775
  • Short report

Atopic myelitis in a European woman residing in Japan

  1. Alan J Thompson1
  1. 1National Hospital for Neurology and Neurosurgery, London, UK
  2. 2Royal National Throat, Nose and Ear Hospital, London, UK
  1. Correspondence to Professor A Thompson, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG; UK; a.thompson{at}ion.ucl.ac.uk
  • Received 24 June 2009
  • Revised 7 March 2010
  • Accepted 15 April 2010
  • Published Online First 14 August 2010

Abstract

Nearly 100 cases of atopic myelitis have been reported in Japan. However, it has only been described in two non-Japanese patients, both from Western Europe. We report a European individual who developed cervical myelitis while resident in Japan. This showed a partial response to corticosteroids. There was no clinical or radiological dissemination for over 5 years, at which time she had a brainstem relapse caused by a new lesion in the medulla oblongata. The patient had high serum total IgE with evidence of allergy to several antigens, including house dust mite and soya. It is possible that the incidence of atopic myelitis may be underestimated where it is not standard practice to measure serum IgE levels in patients with myelopathy. Such cases will instead be subsumed into the diagnostic category of clinically isolated syndrome. However, it remains uncertain whether atopic myelitis is a distinct disease or falls within the spectrum of demyelinating diseases. Further studies are required to fully elucidate the relationship between atopy and the incidence and severity of CNS inflammatory disorders.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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