A Case of Subacute Combined Degeneration of the Spinal Cord with Infective Endocarditis.
A Case of Subacute Combined Degeneration of the Spinal Cord with Infective Endocarditis.
复制标题
脊髓亚急性联合变性合并感染性心内膜炎一例。
DOI：
10.1155/2015/327046
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发表时间：
2015
影响因子：
0.9
通讯作者：
Tian DS
中科院分区：
文献类型：
--
作者：
Huang XJ;He J;Qu WS;Tian DS
背景亚急性联合变性（SCD）是脊髓背柱和侧柱脱髓鞘的一种罕见原因，也是钴胺素缺乏引起的神经源性并发症。慢性病贫血（ACD）发生在急性或慢性免疫激活的患者中，包括感染性心内膜炎。ACD患者是否对SCD更敏感仍有待阐明。SCD合并ACD的病例报道较少。我们报告了一例36岁SCD男性患者，有二尖瓣关闭不全病史超过20年，因步态障碍、下肢无力和感觉异常以及本体感觉丧失8个月而从另一家医院入院并转运至我院。重要的实验室检查结果和超声心动图提示缺铁性贫血和感染性心内膜炎（IE）。MRI显示脊髓背侧柱选择性脱髓鞘改变，证实SCD的诊断。因此，ACD患者可能患有SCD，3T磁共振成像可以诊断SCD。
Background. Subacute combined degeneration (SCD) is a rare cause of demyelination of the dorsal and lateral columns of spinal cord and is a neurogenic complication due to cobalamin deficiency. Anemia of chronic disease (ACD) occurs in patients with acute or chronic immune activation, including infective endocarditis. It remains to be elucidated whether ACD patients are more sensitive to suffer from SCD. Little cases about SCD patients accompanied with ACD have been reported till now. Here we reported a 36-year-old man with SCD with a medical history of mitral inadequacy over 20 years, who was admitted and transported from another hospital to our hospital due to an 8-month history of gait disturbance, lower limb weakness and paresthesia, and loss of proprioception. Significant laboratory results and echocardiography suggest iron deficiency anemia and infective endocarditis (IE). The SCD diagnosis was confirmed by MRI, which showed selective demyelination in the dorsal and lateral columns of spinal cord. In conclusion, the ACD patients may suffer from SCD, which can be diagnosed by 3 Tesla magnetic resonance imaging.