Longitudinal myelitis as an initial manifestation of systemic lupus erythematosus.
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.
Chen
Hsiang-Cheng
HC
Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Lai
Jenn-Haung
JH
Juan
Chun-Jung
CJ
Kuo
San-Yuan
SY
Chen
Chen-Hung
CH
Chang
Deh-Ming
DM
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*