原発性抗リン脂質抗体症候群による急性横断性脊髄炎の1例

Transverse Myelitis in a Patient with Primary Antiphospholipid Syndrome: A Case Report

　原発性抗リン脂質抗体症候群と考えられ急性横断性脊髄炎を併発した32歳，女性例を報告した。右上下肢の脱力，自発性異常感覚を主訴に入院し，頸髄MRIではC3下端からC5上端にかけて頸髄の腫脹を認め，Gd-DTPAにて不均一に増強された。臨床症状や画像所見はステロイド・パルス療法にて劇的に改善した。原因不明の横断性脊髄炎症例においては，抗リン脂質抗体の検索が必要であると考えられた。

A case of acute transverse myelitis following primary antiphospholipid syndrome was presented. The patient was 32-year-old Japanese female who was admitted to our hospital with paresthesia and weakness of the right upper extremity in September 1995. Neurological examinations revealed slightweakness and hypesthesia of the right arm and leg, impairment of vibration sense below the right knee, and hyperreflexia on the right side. There was no apparent history of systemic lupus erythematosus or multiple sclerosis. Laboratory investigations dis-closed raised anticardiolipine antibody level of the IgG class.