Background Since 2014, the USA has documented three outbreaks of acute flaccid myelitis (AFM). Unique features and treatment responses of this myelitis variant have not been prospectively studied. This study prospectively measured outcomes in paediatric myelitis patients relative to treatments. Methods This was a prospective, multicentre, non-randomised, observational cohort study. The study duration was 5 years and the length of follow-up was 1 year. This study collected data from children and families in North America. Patients were enrolled at academic centres with expertise in myelitis or online via a web portal. Paediatric patients diagnosed with myelitis were eligible for enrolment in the study within 6 months of onset of symptoms. Patients were characterised as transverse myelitis (TM) or the AFM variant based on clinical and radiographic findings. Results The cohort of 90 patients included patients with AFM and TM. Of the 51 patients with AFM there was evidence of two clinically relevant patterns. This included a grey matter restricted form of AFM and a cohort with concomitant white matter that could explain lower extremity motor deficits in patients with lesions restricted to the cervical spine. The improvement in deficits with the use of corticosteroids was similar to what was observed in the TM cohort (p=0.97). Conclusions Clinicians should consider on a case by case basis the approach to therapy for AFM patients. Prospective controlled studies of long-term outcomes would be useful in this growing patient population. Data are available on reasonable request. Data can be provided to researchers with IRB approved/exempt protocols on request and review.

中文翻译：

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急性弛缓性脊髓炎：CAPTURE 研究中记录的长期结果与小儿横贯性脊髓炎的比较

背景 自 2014 年以来，美国记录了三起急性弛缓性脊髓炎 (AFM) 暴发。这种脊髓炎变体的独特特征和治疗反应尚未进行前瞻性研究。这项研究前瞻性地测量了儿童脊髓炎患者相对于治疗的结果。方法 这是一项前瞻性、多中心、非随机、观察性队列研究。研究时间为5年，随访时间为1年。这项研究收集了来自北美儿童和家庭的数据。患者在具有脊髓炎专业知识的学术中心或通过门户网站在线注册。诊断为脊髓炎的儿科患者在症状出现后 6 个月内有资格参加该研究。根据临床和影像学发现，患者被定性为横贯性脊髓炎 (TM) 或 AFM 变异型。结果 90 名患者队列包括 AFM 和 TM 患者。在 51 名 AFM 患者中，有两种临床相关模式的证据。这包括 AFM 的灰质限制形式和伴随白质的队列，可以解释颈椎病变患者的下肢运动缺陷。使用皮质类固醇对缺陷的改善与 TM 队列中观察到的相似（p=0.97）。结论 临床医生应根据具体情况考虑 AFM 患者的治疗方法。长期结果的前瞻性对照研究将有助于这一不断增长的患者群体。可根据合理要求提供数据。