PDF(Pubmed)
Abstract：
A 16-year-old girl with a history of clavicular chronic recurrent multifocal osteomyelitis (CRMO) presented with fever, vomiting, urinary and bowel retention, thigh paresthesia, and back pain for 2 days. The patient had 2 separate viral illnesses within a month prior to presentation. Spine magnetic resonance imaging (MRI) displayed increased T2 hyperintensity of the central grey matter from C3 to the conus medullaris (Figure 1). Findings were consistent with longitudinally extensive transverse myelitis. Cerebrospinal fluid analysis revealed elevated protein (51; reference range: <48 mg/dL), IgG index (.74; reference range <.70), and glucose (99; reference range 40-75 mg/dL). There was pleocytosis of 22 white blood cells (88% lymphocytes and 12% monocytes) with negative AQP4 and MOG antibodies. COVID-19 spike protein was positive with a negative PCR and non-immunized status, suggesting prior infection. Four months later, a pelvic MRI revealed new evidence of CRMO.
摘要：
一名16岁的女孩，有锁骨慢性复发性多灶性骨髓炎（CRMO）的病史，表现为发烧，呕吐,尿潴留,大腿感觉异常,和背部疼痛2天。患者在就诊前一个月内患有2种单独的病毒性疾病。脊柱磁共振成像（MRI）显示，从C3到延髓圆锥的中央灰质T2高强度增加（图1）。研究结果与纵向广泛性横贯性脊髓炎一致。脑脊液分析显示蛋白质升高（51；参考范围：<48mg/dL），IgG指数（.74；参考范围<.70），和葡萄糖（99；参考范围40-75mg/dL）。有22个白细胞（88％的淋巴细胞和12％的单核细胞）的细胞增多，AQP4和MOG抗体均为阴性。COVID-19刺突蛋白阳性，PCR阴性，未免疫状态，提示先前感染。四个月后,骨盆MRI显示了CRMO的新证据.
