Anti TPO Antibodies and Neurological Disorders: Emphasis on Relapsing Myelitis Where Steroids Alone may Not be enough

The present study highlights the anti TPO Antibodies and Neurological Disorders of a 32 year female presented with longitudinally extensive transverse. Autoimmune neurological illnesses have been shown to be related with autoimmune thyroiditis myelitis (LETM) with negative workup for other demyelinating and autoimmune diseases, and positive for anti TPO antibody. The biopsy research on steroid responsive encephalopathy patients has demonstrated that antithyroid antibodies (anti thyroid peroxidase-TPO antibodies) might cause demyelination of the central nervous system.

She was started with steroids and azathioprine and recovered completely over one month period, stopped treatment herself after 5 months, had relapse of myelitis and was put on immunosuppressive treatment, showing improvement. The second patient a 52 year female had recurrent attack of LETM with negative workup for other causes of LETM except positive anti TPO antibody. In her first attack she was given only steroids pulse. After relapse she was treated with steroids and cyclophosphamide pulse, and patient remained relapse free thereafter. So it suggests that in myelitis patients associated with anti TPO antibody steroids alone may not be sufficient and, such patients require long term immunosuppression. Our emphasis is that anti TPO may also predict recurrence and may be an independent marker of recurrence in patients with isolated transverse myelitis which needs further studies to confirm.