Clinical, immunological and MRI features of myelitis with atopic dermatitis (atopic myelitis)

In order to clarify the characteristic features of myelitis with atopic der matitis (AD), we compared the clinical, immunological and MRI findings betw een 14 myelitic patients with AD and 12 myelitic patients without AD. The m yelitic patients with AD showed the following distinct features, compared w ith those without AD. (1) A preferential involvement of the cervical cord, as shown by neurologic as well as MRI examinations (14/14 vs. 5/12; P=0.001 2), (2) paresthesia/dysesthesia as the predominant symptoms and a rare occu rrence of definite muscle weakness (0/14 vs. 5/12; P=0.0120) and dysuria (1 /14 vs. 8/12; P=0.0029), (3) a lower Expanded Disability Status Scale score (mean, 1.5 vs. 3.5; P=0.0018), (4) normal cerebrospinal fluid (CSF) findin gs including those for the IgG index and oligoclonal IgG bands and (5) a pe rsistence of neurologic symptoms and MRI lesions during the follow-up perio ds (mean, 17 months). In addition. both the serum total IgE level and the f requency of specific IgE to Dermatophagoides farinae were significantly hig her in the myelitic patients with AD (median IgE=1266 U/ml, specific IgE 14 /14) than in those without AD (145 U/ml, P=0.0034 and 8/12, P=0.0331, respe ctively) and in 40 healthy controls (86 U/ml, P<0.0001 and 12/40, P<0.0001, respectively). Since myelitis with AD has distinct features and atopy to m ite antigens appears to be the underlying cause of this condition, it may t herefore be a distinct subtype of myelitis. (C) 1999 Elsevier Science B.V. All rights reserved.