Case Report: Is Intravenous Immunoglobulin Important when Used Together with Pulse Steroid! Complete recovery within 1 Month of Pediatric Patient Diagnosed with Transverse Myelitis

Open Access Macedonian Journal of Medical Sciences Pub Date : 2024-03-06 DOI:10.3889/oamjms.2024.11862

Neda Faraj, Manal AlHawiti, Sarah AlGosi

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Abstract

BACKGROUND: Pediatric acute transverse myelitis (ATM) is a potentially devastating condition with variable outcomes and presents significant demands on health and social care resources. CASE PRESENTATION: The patient in the present study was a 9-year-old boy, unknown to have chronic diseases. He was presented to Maternity and Children Hospital, Tabuk, with a history of acute progressive onset of unsteady gait and imbalance with pictures of encephalopathy. “Change level of consciousness” for >1 week, preceded by fever and upper respiratory tract infection symptoms. Physical findings were very suggestive and consistent with ATM. Diagnosis was confirmed by blood investigations, lumbar puncture analysis, and magnetic resonance imaging (MRI) brain, and spine. The analysis of lumbar puncture (cerebrospinal fluid) showed high white blood cells count and high protein level “more than 500.” The findings of MRI brain and spine were consistent with TM. The treatment was done initially with intravenous immunoglobulin (IVIG) by a dose of 2 g/kg divided over 2–4 days; followed by a dose of IV pulse steroid, 30 mg/kg/dose of methylprednisolone once a day for 3 days, with close monitor. The patient had a full physical and radiological recovery within less than one month. In conclusion, IVIG showed a significant role in the management of ATM together with steroid. CONCLUSION: IVIG showed a significant role in the management of ATM and could be used as a supportive treatment together with IV pulse steroid. IVIG showed a good efficacy with no serious complications.

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病例报告：静脉注射免疫球蛋白与脉冲类固醇同时使用是否重要？被诊断为横贯性脊髓炎的小儿患者在一个月内完全康复

背景：小儿急性横贯性脊髓炎（ATM）是一种具有潜在破坏性的疾病，其预后不一，对医疗和社会护理资源的需求很大。他因急性进行性步态不稳和失衡并伴有脑病症状而被送往塔布克妇幼医院。"意识水平改变 "超过一周，之前有发烧和上呼吸道感染症状。体格检查结果具有很强的提示性，与 ATM 相吻合。血液检查、腰椎穿刺分析、脑部和脊柱磁共振成像（MRI）证实了诊断结果。腰椎穿刺（脑脊液）分析显示白细胞计数高，蛋白质水平高，"超过 500"。脑部和脊柱核磁共振成像结果与 TM 一致。治疗最初采用静脉注射免疫球蛋白（IVIG），剂量为 2 克/千克，分 2-4 天注射；然后是静脉注射脉冲类固醇，剂量为 30 毫克/千克/次甲基强的松龙，每天一次，连续 3 天，并进行密切监测。患者在不到一个月的时间内，身体和影像学完全康复。结论：IVIG 在治疗 ATM 中发挥了重要作用，可与静脉脉冲类固醇一起作为辅助治疗。IVIG疗效良好，无严重并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Open Access Macedonian Journal of Medical Sciences Medicine-Medicine (all)

自引率

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发文量

1225

期刊介绍： Open Access Macedonian Journal of Medical Sciences (OAMJMS) [formerly known as Macedonian Journal of Medical Sciences] is a top-tier open access medical science journal published by the ID Design 2012/DOOEL Skopje, Rajko Zhinzifov No 48, 1000 Skopje, Republic of Macedonia. OAMJMS is an international, modern, general medical journal covering all areas in the medical sciences, from basic studies to large clinical trials and cost-effectiveness analyses. We publish mostly human studies that substantially enhance our understanding of disease epidemiology, etiology, and physiology; the development of prognostic and diagnostic technologies; trials that test the efficacy of specific interventions and those that compare different treatments; and systematic reviews. We aim to promote translation of basic research into clinical investigation, and of clinical evidence into practice. We publish occasional studies in animal models when they report outstanding research findings that are highly clinically relevant. Our audience is the international medical community as well as educators, policy makers, patient advocacy groups, and interested members of the public around the world. OAMJMS is published quarterly online version. The Open Access Macedonian Journal of Medical Sciences (OAMJMS) publishes Medical Informatics, Basic Science, Clinical Science, Case Report, Brief Communication, Public Health, Public Policy, and Review Article from all fields of medicine and related fields. This journal also publishes, continuously or occasionally, the bibliographies of the members of the Society, medical history, medical publications, thesis abstracts, book reviews, reports on meetings, information on future meetings, important events and dates, and various headings which contribute to the development of the corresponding scientific field.