gms | German Medical Science

45. Kongress der Deutschen Gesellschaft für Rheumatologie, 31. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie, 27. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie

06.09. - 09.09.2017, Stuttgart

Behcet disease with transverse myelitis

Meeting Abstract

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  • Nehal El Shater - Sohag University Hospital, Rheumatology, Sohag, Egypt
  • Esam Abu-Alfadl - Sohag University, Faculty of Medicine, Rheumatology, Sohag, Egypt
  • Mohamed Ismail - Sohag University Hospital, Rheumatology and Rehabilitation, Sohag, Egypt

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. 45. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 31. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), 27. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Stuttgart, 06.-09.09.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocFA.46

doi: 10.3205/17dgrh044, urn:nbn:de:0183-17dgrh0449

Published: September 4, 2017

© 2017 El Shater et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

A 26 years old Egyptian young man at the hospital (Sohag University Hospital) with an acute paralysis of both lower limbs. His history of 4 years duration, he had presented to the neurology department with persistent fever for 10 days, it reached up to 40 degrees, improved shortly on antipyretics. Not associated with shivering or sweating.

It is associated with an acute onset of bilateral lower limbs, weakness and acute urine retention.

Neurological examination:

  • Revealed flaccid paralysis of both lower limbs.
  • Muscle power is zero in both lower limbs
  • There was areflexia.
  • There was a high level of T10.
  • There was no skin rash.

Shortly after, The patient developed spasticity in both quadriceps and abductors magnums.

Both muscles are around score 2 by Modified Ashworth Scale.

So, he suffered from urinary incontinence and sometimes attacks of urine retention.

Cerebrospinal fluid aspiration:

  • WBC count 105 mainly lymphocytes
  • protein 50 mg / dl (which is slightly elevated)
  • glucose 2.5 mmol / l.
  • Paired serum glucose, which is 5.5 mmol / l (45.4%), which is within normal range.
  • Negative culture and sensitivity.

Magnetic resonance imaging of the brain and spinal cord:

The lower thoracic cord from T10 to T12 is expanded and demonstrated on ill-defined T2 hyperintensities in two segments.

Within one year, the patient began to complain of recurrent orally ulcerations, (More than 3 times / year), they were painful, presented on the tongue and buccal mucosa, healed without scarring).

So, genital ulcerations over the penis they were painful and healed without scarring.

Pseudo folliculitis and acneiform lesions in the back and face.

Arthralgia bilaterally on both knees and shoulders without manifestations of arthritis.

The patient also complained of blurring of vision and gradual decrease in visual acuity in the left eye.

At this point our patient is diagnosed as neurobehcet disease and his present symptom is transverse myelitis.

At, the patient is referred to our department as an autoimmune ch is transverse myelitis So, genital ulcerations over the penis they were painful and healed without scarring. Pseudo folliculitis and acneiform lesions in the back and face. Arthralgia bilaterally on both knees and shoulders without manifestations of arthritis. The patient also complained of blurring of vision and gradual decrease in visual acuity in the left eye. At this point our patient is diagnosed as neurobehcet disease and his present symptom is transverse myelitis. At, the patient is referred to our department as an autoimmune ch is transverse myelitis So, genital ulcerations over the penis they were painful and healed without scarring. Pseudo folliculitis and acneiform lesions in the back and face. Arthralgia bilaterally on both knees and shoulders without manifestations of arthritis. The patient also complained of blurring of vision and gradual decrease in visual acuity in the left eye. At this point our patient is diagnosed as neurobehcet disease and his present symptom is transverse myelitis. At, the patient is referred to our department as an autoimmune ch is transverse myelitis Arthralgia bilaterally on both knees and shoulders without manifestations of arthritis. The patient also complained of blurring of vision and gradual decrease in visual acuity in the left eye. At this point our patient is diagnosed as neurobehcet disease and his present symptom is transverse myelitis. At, the patient is referred to our department as an autoimmune ch is transverse myelitis Arthralgia bilaterally on both knees and shoulders without manifestations of arthritis. The patient also complained of blurring of vision and gradual decrease in visual acuity in the left eye. At this point our patient is diagnosed as neurobehcet disease and his present symptom is transverse myelitis. At, the patient is referred to our department as an autoimmune ch is transverse myelitis