Cucuzza ME, Pavone P, Garozzo MT, Finocchiaro MC, Greco F, Smilari P, Di Nora A, Ruggieri M, Di Stefano VA. Longitudinal extensive anti-AMPA-GluR3-related transverse myelitis and favorable therapeutic response: A case report and review of literature. World J Clin Pediatr 2026; 15(1): 113155 [DOI: 10.5409/wjcp.v15.i1.113155]
Corresponding Author of This Article
Maria Elena Cucuzza, DM, Department of Pediatric Unit and Pediatric Emergency Room, Emergency Hospital Cannizzaro, Via Messina 829, Catania 95100, Italy. me.cucuzza@gmail.com
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Pediatrics
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Case Report
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Mar 9, 2026 (publication date) through Mar 9, 2026
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World Journal of Clinical Pediatrics
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2219-2808
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Cucuzza ME, Pavone P, Garozzo MT, Finocchiaro MC, Greco F, Smilari P, Di Nora A, Ruggieri M, Di Stefano VA. Longitudinal extensive anti-AMPA-GluR3-related transverse myelitis and favorable therapeutic response: A case report and review of literature. World J Clin Pediatr 2026; 15(1): 113155 [DOI: 10.5409/wjcp.v15.i1.113155]
World J Clin Pediatr. Mar 9, 2026; 15(1): 113155 Published online Mar 9, 2026. doi: 10.5409/wjcp.v15.i1.113155
Longitudinal extensive anti-AMPA-GluR3-related transverse myelitis and favorable therapeutic response: A case report and review of literature
Maria Elena Cucuzza, Piero Pavone, Maria T Garozzo, Maria C Finocchiaro, Filippo Greco, Pierluigi Smilari, Alessandra Di Nora, Martino Ruggieri, Vita A Di Stefano
Maria Elena Cucuzza, Maria T Garozzo, Maria C Finocchiaro, Vita A Di Stefano, Department of Pediatric Unit and Pediatric Emergency Room, Emergency Hospital Cannizzaro, Catania 95100, Italy
Piero Pavone, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Catania 95100, Italy
Filippo Greco, Pierluigi Smilari, Alessandra Di Nora, Martino Ruggieri, Department of Clinical and Experimental Medicine, Pediatric Clinic, University of Catania, Catania 95100, Italy
Author contributions: Cucuzza ME and Garozzo MT acquisition of data and drafting the article; Cucuzza ME and Pavone P analysis and interpretation of data; Cucuzza ME conception and design; Pavone P drafting and revising the article critically for important intellectual content; Finocchiaro MC, Greco F, Smilari P, Di Nora A, Ruggieri M, and Di Stefano VA formal analysis and investigation.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Maria Elena Cucuzza, DM, Department of Pediatric Unit and Pediatric Emergency Room, Emergency Hospital Cannizzaro, Via Messina 829, Catania 95100, Italy. me.cucuzza@gmail.com
Received: August 18, 2025 Revised: September 16, 2025 Accepted: December 1, 2025 Published online: March 9, 2026 Processing time: 202 Days and 2.7 Hours
Abstract
BACKGROUND
Longitudinally extensive transverse myelitis (LETM) is defined as a spinal cord lesion that extends over three or more consecutive vertebral segments. It is a key manifestation of various inflammatory and demyelinating disorders of the central nervous system. We have described a rare case of a probable association between LETM and the presence of high serum and cerebrospinal fluid levels of metabotropic glutamate receptor 3 antibodies (mGluR3abs) in a 5-year-old girl. LETM is a neurological disorder characterized by a spinal cord lesion extending over three or more vertebral segments.
CASE SUMMARY
We report a case of a 5-year-old Caucasian girl affected by LETM, along with a review of the literature. The patient presented with lower back pain, varying degrees of bilateral sensory and motor deficits, and autonomic dysfunction. Magnetic resonance imaging showed hyperintense signals involving the spinal cord from C3 to the conus medullaris, suggesting a diagnosis of LETM. Laboratory analysis revealed high levels of mGluR3abs in both serum and cerebrospinal fluid. The patient responded favorably to treatment with high doses of intravenous methylprednisolone and immunoglobulin therapy, which has been shown to be particularly effective in children.
CONCLUSION
The frequency of LETM associated with mGluR3abs is unknown; this report may contribute to expanding the understanding of it.
Core Tip: This case report describes a potential link between longitudinally extensive transverse myelitis (LETM) and high levels of GluR3abs receptor 3 in a 5-year-old girl. LETM is a neurological disorder marked by a spinal cord lesion spanning three or more vertebral segments. The girl presented with lower back pain, bilateral sensory, motor impairments, and autonomic dysfunction. She had a positive response to high doses of intravenous methylprednisolone and immunoglobulin therapy. The frequency of LETM associated with GluR3abs is unknown, but this case could help expand understanding of this rare condition.
