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Longitudinal extensive transverse myelitis with an abnormal uFLC ratio in a pediatric patient: Case report and literature review.

Abstract The serum and urine-free light chain (sFLC/uFLC) ratios of kappa (κ) to lambda (λ) serve as biomarkers for plasma cell disorders, especially multiple myeloma. However, to our best knowledge, the ratios have not been appropriately assessed for acute transverse myelitis (ATM).
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29384915
OWN - NLM
STAT- In-Process
LR  - 20180131
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 52
DP  - 2017 Dec
TI  - Longitudinal extensive transverse myelitis with an abnormal uFLC ratio in a
      pediatric patient: Case report and literature review.
PG  - e9389
LID - 10.1097/MD.0000000000009389 [doi]
AB  - RATIONALE: The serum and urine-free light chain (sFLC/uFLC) ratios of kappa
      (kappa) to lambda (lambda) serve as biomarkers for plasma cell disorders,
      especially multiple myeloma. However, to our best knowledge, the ratios have not 
      been appropriately assessed for acute transverse myelitis (ATM). PATIENT
      CONCERNS: We present a 12-year-old boy who had sudden onset low back pain
      following paralysis of his 4 extremities and disturbance consciousness. Magnetic 
      resonance imaging (MRI) of the brain and spine indicated diffuse hyperintensity
      in T2-weighted images from the cervical spinal cord to the conus medullaris. An
      abnormal serum M-peak and uFLC ratio were detected in acute stage. DIAGNOSES:
      Based on the image findings, laboratory findings, and physical examination
      results, the diagnosis of acute transverse myelitis was established.
      INTERVENTIONS AND OUTCOMES: With the treatment of pulse therapy and 5 courses of 
      plasmapheresis, the patient had improvement in expanded disability status scale
      (EDSS) score from 9 to 5. Besides, the kappa/lambda ratio was also returned
      within the normal range. LESSON: The case presented an unusual phenomenon of
      transient abnormal kappa/lambda ratio combined with an M-peak in the acute course
      of longitudinally extensive transverse myelitis (LETM), which revealed FLC ratio 
      recovering accompany with the improvement of disease. Further studies are
      required to identify the association between ATM and monoclonal gammopathy of
      undetermined significance (MGUS).
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Hsu, Po-Chang
AU  - Hsu PC
AD  - Department of Pediatrics, Tri-Service General Hospital.
FAU - Chen, Shyi-Jou
AU  - Chen SJ
AD  - Department of Pediatrics, Tri-Service General Hospital.
AD  - Department of Microbiology and Immunology, National Defense Medical Center,
      Taipei, Taiwan.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
EDAT- 2018/02/01 06:00
MHDA- 2018/02/01 06:00
CRDT- 2018/02/01 06:00
PHST- 2018/02/01 06:00 [entrez]
PHST- 2018/02/01 06:00 [pubmed]
PHST- 2018/02/01 06:00 [medline]
AID - 10.1097/MD.0000000000009389 [doi]
AID - 00005792-201712290-00023 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(52):e9389. doi: 10.1097/MD.0000000000009389.