Systemic Lupus Erythematosus Related Transverse Myelitis Presenting Longitudinal Involvement of the Spinal Cord

Yu-ko KIMURA KATO; Yoshihiko SEIKO; Yoshiyuki HIRAYAMA; Takumi ARAMAKI; Hiroshi YAMAGUCHI; Hiroyuki AMANO; Teruo TAKANO

doi:10.2169/internalmedicine.41.156

Yu-ko KIMURA KATO, Yoshihiko SEIKO, Yoshiyuki HIRAYAMA, Takumi ARAMAKI, Hiroshi YAMAGUCHI, Hiroyuki AMANO, Teruo TAKANO

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Keywords: systemic lupus erythematosus, transverse myelitis, magnetic resonance imaging, magnetic resonance angiography, steroid pulse therapy, cyclophosphamide pulse therapy, plasmapheresis

JOURNAL FREE ACCESS

2002 Volume 41 Issue 2 Pages 156-160

DOI https://doi.org/10.2169/internalmedicine.41.156

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Abstract

Lupus-related transverse myelitis is a rare but serious complication. A 25-year-old Japanese woman with systemic lupus erythematosus (SLE) was admitted because of numbness of the face and left upper extremity, headache, and intermittent fever. Six days later, she developed tetraplegia. MRI of the spinal cord showed longitudinal high intensity signals from medulla oblongata to C5, and from Thl2 to conus medullaris on T2-weighted image. These MRI findings were consistent with acute catastrophic neurological abnormalities. Despite administration of the combination of methylprednisolone and cyclophosphamide pulse therapies, as well as plasmapheresis, her condition did not improve. Any vasculopathy in addition to the autoimmune pathogenesis, and narrow therapeutic window may relate to the present refractory case.
(Internal Medicine 41: 156-160, 2002)

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