脊髄腫瘍と鑑別を要したアトピー性脊髄炎の1例

An Atopic Myelitis Discriminated with a Spinal Cord Tumor. Case Report

　症例は26歳の女性で，主訴は両上肢の感覚障害，巧緻運動障害，排尿障害であった．画像上，脊髄腫瘍に加え脊髄炎，脊髄変性疾患なども疑われ神経内科医より紹介された．検査で高IgE血症，ダニ，ハウスダストのアレルゲン特異性IgE抗体の高値を認め，アトピー性脊髄炎が疑われた．そのためステロイド療法が開始され，症状，画像の改善を認めた．このように脊髄内病変で診断に難渋する場合，神経内科医と連携するとともに，ステロイド投与での経過観察が診断の一助となることがある．

　A 26-year-old woman noticed clumsiness in her finger motions, numbness in both upper and lower limbs, and urinary disturbance.　An MRI showed a tumor-like change within the spinal cord at C3-7.　She was also referred to neurology because her symptomatic onset was sudden, and the MRI needed differentiation of myelitis and the spinal cord disorders as well as spinal cord tumors.　She had the history of allergic dermatitis in her childhood, and a high IgE antibody.　Furthermore, her antigen-antibody reaction for both tick and house dust was positive.　As for her diagnosis, the atopic myelitis was selected.　She was taken steroid therapy for a year.　Her symptom was gradually improved.　It is important for a spinal cord lesion to differentiate spinal cord tumors, myelitis, and spinal cord disorders.　In consultation with a neurologist, the steroid therapy may be helpful in diagnosing for a spinal cord lesion.