Subacute combined degeneration of spinal cord with autoimmune disease in children: a case report
10.3760/cma.j.cn113694-20220610-00468
- VernacularTitle:儿童脊髓亚急性联合变性伴自身免疫性疾病1例
- Author:
Changhui LANG
1
;
Xinxing XIE
;
Maoqiang TIAN
;
Juan LI
;
Wenting LEI
;
Xiaomei SHU
Author Information
1. 遵义医科大学附属医院/贵州省儿童医院小儿内科，遵义 563003
- Keywords:
Subacute combined degeneration;
Vitamin B12;
Antibodies, antineutrophil cytoplasmic;
Connective tissue diseases;
Autoimmune polyglandular syndrome
- From:
Chinese Journal of Neurology
2023;56(3):319-323
- CountryChina
- Language:Chinese
-
Abstract:
The clinical manifestations of subacute combined degeneration of spinal cord (SCD) in children are complex and vary greatly. Due to the fact that some patients with SCD may be complicated with autoimmune diseases, the high early misdiagnosis and missed diagnosis rates are observed. One case of 13-year old female with severe anemia, multiple joint swelling and pain in left limbs and paralysis of bilateral lower limbs with the extremely low level of serum vitamin B12 and poly-glandular involvement as well as a variety of positive auto-antibodies (anti-intrinsic factor antibody, anti-parietal cell antibody, thyroid peroxidase antibody, thyroid globulin antibody and perinuclear anti-neutrophil cytoplasmic antibody) was retrospectively analyzed. The patient was diagnosed as SCD with autoimmune disease (undifferentiated connective tissue disease and autoimmune polyglandular syndrome). The patient′s condition gradually alleviated after high-dose intravenous methylprednisolone, immunoglobulin, naproxen (then changed to hydroxychloroquine 1 month later), vitamin B12 and levothyroxine sodium tablets supplementation, blood transfusion and rehabilitation. SCD with autoimmune diseases is rare in children, and the clinical manifestations vary greatly. Early recognition and early treatment can improve the prognosis of SCD. The clinical data of this child were retrospectively analyzed, so as to improve the understanding of the disease by clinicians.
