PDF(Pubmed)
Abstract：
Acute transverse myelitis (ATM) is an inflammatory disorder caused by many etiologies, from postinfectious to autoimmune. Rarely, ATM cases have been reported after both COVID-19 infection and COVID-19 vaccination. We described our experience with ATM after COVID-19 infection and conducted a literature review.
UNASSIGNED: We reported a case of longitudinally extensive ATM after COVID 19 infection, who also received convalescent plasma therapy, and present a comprehensive literature review of ATM cases reported after COVID-19 infection and COVID-19 vaccination. The literature search was done using PubMed and Google scholar with keywords and selected peer-reviewed articles. The search included all cases from Jan 2020 to Sept 2022.
UNASSIGNED: A total of 60 ATM cases reported association with post COVID 19 infection, and 23 ATM cases reported association with post COVID 19 vaccinations. Among post COVID 19 ATM cases, the mean age was 49 years and the youngest reported was 7-month-old. A total of 55% (33) were longitudinally extensive ATM. The most common symptom was lower extremity weakness. One case was reported as necrotizing myelitis on biopsy, and another case overlapped with syndrome of GBS and longitudinal ATM. No cases reported using convalescent plasma therapy after infection. Almost all the ATM cases were treated with steroids, but some cases needed additional treatment since not all responded adequately. Six cases (10%) responded with steroids plus plasmapheresis, and 5 cases (8%) responded with steroids + IVIG, especially in the pediatric age group. One case reported a positive response after treatment with eculizumab, and another with infliximab. Two cases (3%) remained paraparetic. Among post covid-19 vaccine ATM cases, 4 cases (17%) were reported as longitudinally extensive ATM. Five cases (21%) had symptom onset within a week after vaccination. Almost all reported a response to steroids except for one case which reported fatality after the 58th day after vaccination.
UNASSIGNED: ATM, in the setting of acute COVID-19 infection, has been described in multiple cases and is a rare complication of COVID-19 vaccination.
UNASSIGNED: We reported a case of longitudinally extensive ATM after COVID 19 infection, who also received convalescent plasma therapy, and present a comprehensive literature review of ATM cases reported after COVID-19 infection and COVID-19 vaccination. The literature search was done using PubMed and Google scholar with keywords and selected peer-reviewed articles. The search included all cases from Jan 2020 to Sept 2022.
UNASSIGNED: A total of 60 ATM cases reported association with post COVID 19 infection, and 23 ATM cases reported association with post COVID 19 vaccinations. Among post COVID 19 ATM cases, the mean age was 49 years and the youngest reported was 7-month-old. A total of 55% (33) were longitudinally extensive ATM. The most common symptom was lower extremity weakness. One case was reported as necrotizing myelitis on biopsy, and another case overlapped with syndrome of GBS and longitudinal ATM. No cases reported using convalescent plasma therapy after infection. Almost all the ATM cases were treated with steroids, but some cases needed additional treatment since not all responded adequately. Six cases (10%) responded with steroids plus plasmapheresis, and 5 cases (8%) responded with steroids + IVIG, especially in the pediatric age group. One case reported a positive response after treatment with eculizumab, and another with infliximab. Two cases (3%) remained paraparetic. Among post covid-19 vaccine ATM cases, 4 cases (17%) were reported as longitudinally extensive ATM. Five cases (21%) had symptom onset within a week after vaccination. Almost all reported a response to steroids except for one case which reported fatality after the 58th day after vaccination.
UNASSIGNED: ATM, in the setting of acute COVID-19 infection, has been described in multiple cases and is a rare complication of COVID-19 vaccination.
摘要：
急性横贯性脊髓炎（ATM）是一种由多种病因引起的炎症性疾病，从感染后到自身免疫。很少,在COVID-19感染和COVID-19疫苗接种后，都报告了ATM病例。我们描述了我们在COVID-19感染后使用ATM的经验，并进行了文献综述。
■我们报告了1例COVID19感染后纵向广泛ATM，他还接受了恢复期血浆疗法，并对COVID-19感染和COVID-19疫苗接种后报告的ATM病例进行了全面的文献综述。使用PubMed和Google学者进行文献检索，并提供关键字和经过同行评审的文章。搜索包括2020年1月至2022年9月的所有案例。
■共有60例ATM病例报告与COVID19后感染有关，23例ATM病例报告与COVID19疫苗接种后相关。在新冠肺炎后ATM病例中，报告的平均年龄为49岁,年龄最小的为7个月.总共55%(33)是纵向广泛的ATM。最常见的症状是下肢无力。活检报告1例坏死性脊髓炎，另一例重叠有GBS综合征和纵向ATM。没有病例报告感染后使用恢复期血浆治疗。几乎所有的ATM病例都用类固醇治疗，但有些病例需要额外的治疗,因为并非所有病例都有充分的反应.6例（10％）对类固醇加血浆置换有反应，5例（8%）对类固醇+IVIG有反应，尤其是在儿科年龄组。1例报告用依库珠单抗治疗后出现阳性反应，另一种是英夫利昔单抗。2例（3％）仍处于旁状态。在covid-19疫苗后的ATM病例中，4例（17％）报告为纵向广泛ATM。5例（21%）在接种疫苗后一周内出现症状。几乎所有人都报告了对类固醇的反应，除了一例在疫苗接种后第58天报告死亡。
■ATM，在急性COVID-19感染的情况下，已在多个病例中被描述，是COVID-19疫苗接种的罕见并发症。
■我们报告了1例COVID19感染后纵向广泛ATM，他还接受了恢复期血浆疗法，并对COVID-19感染和COVID-19疫苗接种后报告的ATM病例进行了全面的文献综述。使用PubMed和Google学者进行文献检索，并提供关键字和经过同行评审的文章。搜索包括2020年1月至2022年9月的所有案例。
■共有60例ATM病例报告与COVID19后感染有关，23例ATM病例报告与COVID19疫苗接种后相关。在新冠肺炎后ATM病例中，报告的平均年龄为49岁,年龄最小的为7个月.总共55%(33)是纵向广泛的ATM。最常见的症状是下肢无力。活检报告1例坏死性脊髓炎，另一例重叠有GBS综合征和纵向ATM。没有病例报告感染后使用恢复期血浆治疗。几乎所有的ATM病例都用类固醇治疗，但有些病例需要额外的治疗,因为并非所有病例都有充分的反应.6例（10％）对类固醇加血浆置换有反应，5例（8%）对类固醇+IVIG有反应，尤其是在儿科年龄组。1例报告用依库珠单抗治疗后出现阳性反应，另一种是英夫利昔单抗。2例（3％）仍处于旁状态。在covid-19疫苗后的ATM病例中，4例（17％）报告为纵向广泛ATM。5例（21%）在接种疫苗后一周内出现症状。几乎所有人都报告了对类固醇的反应，除了一例在疫苗接种后第58天报告死亡。
■ATM，在急性COVID-19感染的情况下，已在多个病例中被描述，是COVID-19疫苗接种的罕见并发症。
