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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What can be the cause of idiopathic transverse myelitis and the triggering factor of my immune system?

hi, I m 42 years old male, recently diagnosed for idiopathic transverse myelitis. I’ve Type-2 Diabetic since 2007 and it’s well under control with Metformin.      I’ve been given steroids and Plasmapheresis twice to control my spinal chord inflammation. All the tests came negative for MS, NMO and all other known autoimmune diseases. This time CT Scan was done to check under the spinal chord cancer and that also came negative. All of my blood tests came negative.      First time, I was admitted in Valley Presbyterian hospital on Oct. 17th after they saw lesion in my spinal chord in MRI, I was tread for Transverse Myelitis with 5 dozes of steroids. I was discharged from the hospital and i was able to walk (no oral medicine was given).      I had 1st relapse after 2 weeks, i was transferred to Keck Medical Center of USC. This replace was very severe leaving my lower part of body below the chest area completely paralyzed, lost pain and temperature sensations.      I was treated with 5 dozes of steroids and oral medicine for 2 days but my condition was not getting better so the did 5 days treatment of Plasmapheresis. I was able to move my toes after the Plasmapheresis. I was shifted to rehab and after 7 days, i was able to walk with walker then cane and then without cane slowly (no oral medicine was given).      I had 2nd relapse after 1 month. Luckily we got on time and the condition did not go worse, after 5 days of Plasmapheresis treatment i was discharged on 24th Dec. and now i’m walking again without cane.      This time Dr. has put me on immunosuppressive Prednisone 40mg twice an day until the Azathioprine 50mg once a day kicks in. They will monitor my condition with blood tests to keep my immune system suppress.      It’s idiopathic transverse myelitis and they are not able to find out what triggered my immune system. they will try all the medicine to see which will help to keep my immune system suppress. I know the possible of side effects of weakening my immune system. I would appreciate your response to my question. Thanks in advance for taking time and looking into my request. Raza Waseer
Mon, 19 May 2014
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Oncologist 's  Response
Hello Mr Raza. the word idiopathic means there is no known cause. After having said that it does not imply that there is no cause. Rather it means we donont know the cause. Since plasmaphoresis helped you both times, it is antibodies that are causing problem thats why we call it auto immune. Cause can be viral infection. even some menifestation of known or unknown infection. It could be allergy to something in food or air. Malfunctioning of your immune system as well. Many of these cases never get to know the cause. a lot many lead to tremendous increase in our knowlege and understanding of the disease. Fortunately many are self limiting which keep the candle of hope burning. I hope this answers your question. Wishing you an early complete recovery.
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