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Fırat Üniversitesi Sağlık Bilimleri Tıp Dergisi
2010, Cilt 24, Sayı 2, Sayfa(lar) 133-136
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Recurrent Myelitis Connected With High HBs Ag Level
Aybala Neslihan ALAGOZ1, Şerefnur ÖZTÜRK2, Şenay ÖZBAKIR2
1Kocaeli Devlet Hastanesi, Nöroloji Kliniği, Kocaeli, TÜRKİYE
2Ankara Numune Eğitim ve Araştırma Hastanesi, I. Nöroloji Kliniği, Ankara, TÜRKİYE
Keywords: Myelitis, HBs Ag

Recurrent demyelinating transverse myelitis is a disease which can occur with different causes. It is stated that being HBs Ag carrier could be the reason of recurrent demyelinating transverse myelitis which can be cured with corticosteroids. 32 years old male patient consulted hospital with pain, paresthesia, weakness continuing for 15 days in both of the lower extremity. It was learned that the patient had paraparesia, urinary incontinence and loss of sense giving degrees; compatible with myelitis, with a 4 times similar previous myelitis attacks history. In that period, laboratory examinations were also consistent with myelitis. In the neurological examination of the patient at the last consultation, paraparesia, spastisity, tendon reflexes which are hyperactive distinctively on the left, bilateral Babinsky (+), bilateral Achille clonus (+), and T8 sense disorder giving degree was detected. In laboratory examinations: except ESR: 102 mm/h, complete blood count and biochemical examinations were found normal. In CSF examination: vision was found clear, protein:25 mg/dl, glucose:47 mg/dl. There was no generation in the culture, Brucella and Sy were (-), no cell was observed in microscopy, oligoclonal band was (-), Ig G index was: 0,26, CRP: 21,8 mg/dl. Hepatitis markers other than HBs Ag (+; 44,69) were negative. VEP; was normal. In the abdomen USG, neurogenic bladder and successive hidronefrosis was observed. Urodynamic tests were consistent with detrusor sphincter dissynergy. In thoracal MRI, hyperintense area with maximum 1 cm diameter at the level of T11-12 was detected in medulla spinalis. With seven day, 1 gr/day prednisolon treatment, improvement was observed in the loss of strength and sense level. It has been stated that being Hepatitis B Ag positive may be the reason of recurrent myelitis by immunological mechanisms. In our case, this togetherness was investigated in the light of literature.

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