Acute transverse myelitis after acute hepatitis a: findings on magnetic resonance imaging.

摘要

A 33-year-old man was admitted to our department because of fever, myalgia, nausea, and vomiting. His liver function test revealed elevation of the hepatic enzyme and hyperbilirubinemia, ie, AST 213 IU, ALT 1105 IU, and total bilirubin 7.5 mg/dL. Hepatitis A serologic test, ie, HAV IgM, was positive, and serologic tests for hepatitis B and C were negative. While his liver function test results were improving, he was discharged with the diagnosis of recovery state of acute hepatitis A. Five days later, he was readmitted with constipation, urinary retention, and weakness in the low extremities. He also complained of hypersthenia of trunk and legs. A physical examination revealed grade I of motor weakness in both low extremities, with bilateral positive Babinski's sign, deep tendon reflex (grade II), and ankle clonus. Lab testing on admission included AST 49 IU, ALT 185 IU, total bilirubin 12.3 mg/dL, alkaline phosphatase 142 IU, gamma-glutanyl transpeptidase 116 U, lactate dehydrogenase 460 U/L, and prothrom-bin time international normalized ratio 1.0.