title: Longitudinal myelitis as an initial manifestation of systemic lupus erythematosus.
abstract: Transverse myelitis is a rare and serious complication of systemic lupus erythematosus (SLE). A longitudinal involvement of the spinal cord with lupus-related transverse myelitis is more unusual. Only 7 cases have been reported. We describe a 53-year-old woman presenting with short-term paraplegia as an initial manifestation of SLE with longitudinal myelitis. She had a partial response to treatment with pulse cyclophosphamide and high-dose corticosteroids after follow-up more than 2 years. To the best of our knowledge, this is the first case report of "longitudinal" myelitis as an initial presentation of SLE. Magnetic resonance imaging typically shows increased signal intensity in T2-weighted images, cord swelling, and contrast enhancement over several spinal segments. The possibility of SLE should be kept in mind in women presenting with paraplegia with no apparent cause.
authors.affiliation: Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Hsiang-Cheng
authors.initials: HC
authors.lastname: Chen
authors.forename: Jenn-Haung
authors.initials: JH
authors.lastname: Lai
authors.forename: Chun-Jung
authors.initials: CJ
authors.lastname: Juan
authors.forename: San-Yuan
authors.initials: SY
authors.lastname: Kuo
authors.forename: Chen-Hung
authors.initials: CH
authors.lastname: Chen
authors.forename: Deh-Ming
authors.initials: DM
authors.lastname: Chang
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009187:Myelitis / Q000209:etiology*; D010264:Paraplegia / Q000209:etiology*