Objective To clarify the clinical features of myelitis associated with atop
ic disorders in Japanese patients.
Subjects and Methods We retrospectively studied the clinical, immunological
and electrophysiological features of 68 consecutive patients with myelitis
of acute or subacute onset diagnosed at Kyushu University Hospital during
the past 20 years.
Results While only 2 of 28 (7%) patients with myelitis diagnosed between 19
79 and 1993 had either atopic dermatitis (AD) or bronchial asthma (BA), 19
of 40 (48%) patients with myelitis diagnosed between 1994 and 1998 did. Amo
ng the 40 patients with myelitis diagnosed between 1994 and 1998, 19 patien
ts with either AD or BA as well as 21 patients without either disease showe
d a significantly higher level of serum total IgE, higher frequency of hype
rIgEaemia and higher frequency of mite antigen-specific IgE than 82 healthy
controls. Myelitis patients with AD presenting as persistent paresthesia/d
ysesthesia in all four limbs showed cervical cord lesions on MRI and abnorm
alities in upper limb motor evoked potentials but no abnormalities in the c
erebrospinal fluid (CSF), while myelitis patients with BA showed preferenti
al involvement of the lower motor neurons clinically and electromyographica
lly. In addition, 12 patients with myelitis who had hyperIgEaemia and mite
antigen-specific IgE but neither AD nor BA showed incomplete transverse mye
litis with mild motor disability and few CSF abnormalities.
Conclusion The clinical features of myelitis associated with atopic disorde
rs were in part distinguished by the type of preceding atopic disorder, and
also were different from those of hyperIgEaemic myelitis with no preceding