Bao Mom was paralyzed just after confinement! It turned out to be immune disorders that caused inflammation of the spinal cord_Shenzhen News Network

"Xiao Bao is almost a year old, and I am also working, which is really good," Zhao Ying (pseudonym), who came to the follow-up clinic, showed a long-lost smile to Dr. Zhang Hongdang. It is hard to imagine that half a year ago she lay in a bed in the Department of Neurology of Shenzhen University General Hospital for 24 days, with a urinary catheter inserted, unable to take care of herself, and always full of sorrow. Chest pain to the back of the whole person can not move at the beginning of the year, 35-year-old Zhao Ying happily gave birth to the second treasure, but not long after the confinement, the body collapsed. First of all, there was a sudden pain in the chest, and the pain in the front chest was like a continuous electricity, very intense, and even woke up at night. The child is small, there are many things at home, Zhao Ying endured for more than a week, did not expect that the condition is getting more and more serious, stomach, thighs numbness, legs are weak, and even there is urination, defecation difficulties, to go to the toilet to have someone to help, people are almost paralyzed, a yuan can not sleep. The family quickly took Zhao Ying to the hospital to see the emergency department, and then successively went to several different departments such as orthopedics, rehabilitation, neurosurgery and other departments for consultation, and finally consulted by Zhang Hongya, deputy chief physician of Shenzhen University General Hospital, and transferred to the neurology ward. Young women, no previous underlying diseases, postpartum, onset of urgency, combined with these factors, Dr. Zhang considered that this may be an immune disease, immediately launched a series of examinations, and indeed found abnormalities: cerebrospinal fluid protein 866.03mg / L, the value is significantly increased blood and cerebrospinal fluid anti-AQP4 antibody positive cervical vertebrae, thoracic nuclear magnetic prompt: cervical 7 thoracic 7 vertebral body level spinal cord abnormal signal cervical spine to thoracic vertebrae, that is, from the neck to the back of the 8 vertebral spinal cord segments, there are lesions, from the image picture, The spinal canal is filled with a long, thickened grayish white, indicating obvious edema and abnormality. Zhao Ying was diagnosed with: optic nerve myelitis spectrum disease. This is an autoimmune disease that mainly affects the optic nerve and spinal cord, seriously affects limb function, and if it is not treated regularly in time, it is likely to lead to lifelong disability. The 15-centimeter-long spinal cord was inflamed, and Dr. Zhang Red Duck was also a little surprised, practicing medicine for more than ten years, which was the longest segment of myelitis she had ever encountered. Knowing that the serious consequences of the disease could make it impossible for this young mother to take care of her child forever, Dr. Zhang was determined to do everything he could. "Solve the problem of prevention" The global new technology B-cell immunotherapy has made a contribution Fortunately, Zhao Ying's admission, examination, and diagnosis are relatively timely, and Dr. Zhang Hongya quickly determined the treatment plan: hormone anti-inflammatory, C-ball impact, nutrition nerves, potassium supplementation, calcium supplementation and stomach protection. Among them, hormones and C balls are conventional means of treating immune diseases, inhibiting the body's own tissues from being damaged by antibodies. On this basis, Dr. Zhang Hongya, who is the leader of the central nervous system infection and immunology team of the Shenzhen Medical Doctor Association, has unveiled a new "big move" - intravenous infusion of ritux maclizumab, which is also a targeted immunotherapy B cell depletion treatment that is currently in full swing around the world. B cell depletion therapy activates a series of immune responses by eliminating naïve B cells and memory cells, which is conducive to reducing the inflammatory response and the production of pathogenic antibodies, so as to achieve the effect of treating and preventing the progression of myelitis. The disease was diagnosed, where did the antibodies that could attack Zhao Ying come from? This is actually the most difficult source to find in the clinic. With extensive experience, Dr. Zhang considered that this might be related to previous infections or tumors causing immune disorders. Therefore, a test for antibodies associated with paraneumplasms was prescribed and the results were positive. However, a systemic examination did not reveal a tumor, but rather suggested the possibility of breast cancer. After personalized conventional treatment and B cell depletion treatment, Zhao Ying's condition improved significantly, the chest and back pain was much better, the bowel movements returned to normal, and people could walk. The film showed that the originally inflamed 8-segment spinal cord had shrunk to 2 and the abnormal signal had been very weak, and the antibody indicators had also been greatly improved. Acute myelitis is almost completely cured, and the risk of breast cancer is greatly reduced. Unexpectedly, the targeted B cell depletion treatment actually played a "double eagle with one stone" effect, and Zhao Ying felt surprised and lucky. After 24 days of hospitalization, Zhao Ying was successfully discharged from the hospital, and Dr. Zhang advised her to take full management after discharge, continue anti-inflammatory treatment, regularly review immune indicators, and adjust the treatment plan. The risk of autoimmune diseases in women is four times higher than that of men, which is especially important for myelitis after childbirth, which is a central nervous system infectious disease (such as tuberculosis, neurosyphilis, Brucellosis, etc.) and central nervous system immune-related diseases (such as multiple sclerosis, optic neuromyelitis spectrum disease, acute disseminated encephalomyelitis and other immune encephalomyelitis such as MOG). Clinical manifestations are chest and back pain or bracing sensation, limb numbness and weakness, urinary stool disorders, etc., and the disability rate is extremely high. Neuromyelitis optica spectrum disorders (NMOSD), the incidence rate is about 15/100,000 people per year, mostly in young adults, women are significantly higher, and the proportion of females and men is as high as (9 to 11):1. Women have a fourfold increased risk of autoimmune diseases compared to men, linked to sex hormones, X chromosomes, microchimerism, environmental factors, and multiple factors in the microbiome. Absolute levels of antibodies are higher in women than in men, and (auto)antibodies are also associated with most autoimmune diseases. Some clinical data suggest that differences in antibodies may lead to an increased prevalence of autoimmune diseases in women, particularly peaks in postpartum serum antibody levels and autoimmunity. Therefore, it is extremely important to pay attention to the health of postpartum women, regular check-ups, and timely medical treatment. Dr. Zhang Hongya, head of the Central Nervous System Infection and Immunology Group of the Neurology Branch of the Shenzhen Medical Doctor Association, reminded the general public that autoimmune diseases of the nervous system can be seen in all groups, and if there are symptoms such as double vision, decreased vision, limb numbness, limb weakness, walking instability, convulsions, urinary and stool disorders, and mental and behavioral abnormalities, they should be treated immediately, and neurology specialties need to be screened and diagnosed, timely and precise treatment, in order to obtain a good prognosis. (The original title was "Bao Ma just came out of the confinement and was paralyzed!") It turned out to be an immune disorder that caused inflammation of the spinal cord") window. HLBath=1; window. HLBath=1;