Myelopathy during treatment for pulmonary tuberculosis

Reid, A.; Bone, Ian

doi:10.1136/pgmj.56.657.511

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…A similar report suggested that clinical improvement can be achieved after steroid therapy. 9 Gupta et al studied MRIs of 20 patients with intraspinal tuberculosis, and revealed that cord edema, cavitation and linear enhancement of the surface of the spinal cord were common; these features are also found in Devic's disease. 10 Some reports suggest a correlation between pulmonary tuberculosis and NMO.…”

Section: Discussionmentioning

confidence: 99%

Anti-tuberculosis treatment for Devic’s neuromyelitis optica

Feng

Guo

Fan

et al. 2010

Journal of Clinical Neuroscience

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Section: Discussionmentioning

confidence: 99%

Anti-tuberculosis treatment for Devic’s neuromyelitis optica

Feng

Guo

Fan

et al. 2010

Journal of Clinical Neuroscience

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“…Another similar case6 showed clinical improvement after steroid therapy. In a small series of patients with neuromyelitis optica (myelopathy and optic neuropathy) and pulmonary tuberculosis7 there was no visual improvement; five of the eight patients showed some degree of amelioration of the spinal cord symptoms but the prognosis was worse than in idiopathic transverse myelitis.…”

Section: Discussionmentioning

confidence: 80%

Transverse myelopathy and radiculomyelopathy associated with pulmonary atypical Mycobacterium infections

White

Al‐Shahi

Gamble

et al. 2001

Thorax

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Myelopathy is a well recognised but rare association with Mycobacterium tuberculosis infection, but has not been described with atypical mycobacteria. We report two cases of disabling myelopathy in association with pulmonary infection by Mycobacterium kansasii and Mycobacterium malmoense; the myelopathy is presumed to be a para-infectious phenomenon. (Thorax 2001;56:158-160 A 23 year old, right handed computer operator with type 1 diabetes mellitus presented with a four month history of weight loss, productive cough, increasing breathlessness, and a one day history of chest pain. On examination the only abnormalities were coarse inspiratory crackles in both upper zones of the chest and some tenderness to the right of the T8 spinous process. Routine biochemical and haematological investigations were normal. Chest radiography showed multiple, bilateral, thin walled cavities in the upper zones. Ziehl-Neilson staining of the sputum confirmed the presence of acid and alcohol fast bacilli. HIV antibody test was negative. Treatment was started with rifampicin, isoniazid, and pyrazinamide.

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“…Relapses in tuberculous myelopathy can recur several times during treatment [ 20 ]. Reid and Bone reported that clinical improvement can be achieved after steroid therapy [ 21 ]. However, disease progression despite adequate ATT treatment is well documented [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Mycobacteria Infection in Incomplete Transverse Myelitis Is Refractory to Steroids: A Pilot Study

Feng

Guo

Liu

et al. 2011

Clinical and Developmental Immunology

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Incomplete transverse myelitis (ITM) of unknown origin is associated with high rates of morbidity and mortality. This prospective, open-label study was undertaken to determine whether antituberculous treatment (ATT) might help patients with ITM whose condition continues to deteriorate despite receiving IV methylprednisolone treatment. The study consisted of 67 patients with steroid-refractory ITM in whom Mycobacterium tuberculosis (MTB) was suspected clinically and in whom other known causes of myelopathy were excluded. The study occurred from January 2003 to June 2010. Patients underwent trial chemotherapy with ATT. Efficacy was assessed by the American Spinal Injury Association (ASIA) scoring system, the Barthel Index (BI) and the Hauser Ambulation Index (AI) at baseline, 12 months, and 24 months, using magnetic resonance imaging (MRI). Of the 67 patients enrolled, 51 were assessed and 16 withdrew. At 24 months, 49 patients experienced benefits as indicated by significantly increased ASIA and BI scores. The Hauser AI index also improved with markedly decreased abnormal signals in spinal cord MRI over time. The results from this prospective study provide beneficial clinical and MRI data on the efficacy of ATT in ITM patients and suggests mycobacteria may be an important and neglected cause of myelitis.

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Myelopathy during treatment for pulmonary tuberculosis

Abstract: A patient who developed a myelopathy during a course of treatment for pulmonary tuberculosis is described. The underlying mechanisms and problems in diagnosis are discussed.

Cited by 3 publications

References 5 publications

Anti-tuberculosis treatment for Devic’s neuromyelitis optica

Anti-tuberculosis treatment for Devic’s neuromyelitis optica

Transverse myelopathy and radiculomyelopathy associated with pulmonary atypical Mycobacterium infections

Mycobacteria Infection in Incomplete Transverse Myelitis Is Refractory to Steroids: A Pilot Study

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