Objective: It may be difficult for clinicians to estimate the prognosis of pediatric acute transverse myelitis (ATM). The aim of this study was to define prognostic factors for relapsing disease and poor outcome in pediatric ATM. Methods: This prospective cohort study included 49 children, 18 boys and 31 girls (median age 13.1 years, IQR 6.5–16.2) with a first episode of ATM. Factors associated with relapsing disease and poor outcome (Expanded Disability Status Scale (EDSS) 4) were assessed during a median follow-up of 37 months (IQR 18–75). Results: In total, 14 patients (29%) experienced 1 relapse(s) and nine patients (18%) had a poor outcome. Factors at onset associated with relapsing disease included higher age (16.1 vs. 11.6 years, p = 0.002), longer time to maximum severity of symptoms (5.5 vs. 3 days, p = 0.01), lower maximum EDSS score (4.0 vs. 6.5, p = 0.003), short lesion on spinal MRI (64 vs. 21%, p = 0.006), abnormalities on brain MRI (93 vs. 44%, p = 0.002) and presence of oligoclonal bands in cerebrospinal fluid (67 vs. 14%, p = 0.004). The only factor associated with poor outcome was presence of a spinal cord lesion on MRI without cervical involvement (56 vs. 14%, p = 0.02). Conclusion: Pediatric ATM patients presenting with clinical, radiological and laboratory features associated with multiple sclerosis (MS) are at risk for relapsing disease. In absence of these known MS risk factors at onset of disease these patients are at low risk for relapses. Only a minority of pediatric ATM patients in this cohort have a poor outcome. 2020 Published by Elsevier B.V. on behalf of The Japanese Society of Child Neurology. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

中文翻译：

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小儿急性横贯性脊髓炎复发和预后的预后因素

目的：临床医生可能难以估计小儿急性横贯性脊髓炎（ATM）的预后。本研究的目的是确定儿科 ATM 疾病复发和预后不良的预后因素。方法：这项前瞻性队列研究包括 49 名儿童，18 名男孩和 31 名女孩（中位年龄 13.1 岁，IQR 6.5-16.2），首次发作 ATM。在 37 个月的中位随访期间（IQR 18-75）评估了与疾病复发和不良结果相关的因素（扩展残疾状态量表 (EDSS) 4）。结果：总共有 14 名患者 (29%) 经历了 1 次复发，9 名患者 (18%) 的结果不佳。与疾病复发相关的发病因素包括较高的年龄（16.1 岁对 11.6 岁，p = 0.002），症状达到最大严重程度的时间较长（5.5 天对 3 天，p = 0.01），最大 EDSS 评分较低（4. 0 vs. 6.5, p = 0.003)、脊髓 MRI 上的短病变 (64 vs. 21%, p = 0.006)、脑部 MRI 异常 (93 vs. 44%, p = 0.002) 和脑脊液中存在寡克隆带（67 对 14%，p = 0.004）。与不良结果相关的唯一因素是 MRI 上存在脊髓损伤而没有颈椎受累（56% vs. 14%，p = 0.02）。结论：具有与多发性硬化症 (MS) 相关的临床、放射学和实验室特征的儿科 ATM 患者有复发疾病的风险。在疾病发作时缺乏这些已知的 MS 风险因素，这些患者的复发风险较低。该队列中只有少数儿科 ATM 患者的预后不佳。2020 年 Elsevier BV 代表日本儿童神经病学会出版。这是 CC BY 许可下的开放获取文章 (http: