Transverse myelitis, a rare neurological manifestation of mixed connective tissue disease--a case report and a review of literature.
Although neurological involvement occurs in about 10% of patients with mixed connective tissue disease (MCTD), acute transverse myelitis (TM) has only been described in seven cases of MCTD. We hereby report a case of 70-year-old white female with transverse myelitis complicating her underlying MCTD. Our patient presented with lower extremity weakness, loss of sensation and incontinence one year after her diagnosis of MCTD. Her work-up revealed an abnormal MRI, with findings consistent with TM. She had an excellent response to initial therapy with six cycles of monthly intravenous immunoglobulins and steroids, with subsequent maintenance on azathioprine. She had a good neurological recovery with mild residual sequelae only. On basis of this case report and review of literature, we recommend ongoing surveillance and reporting of this rare neurological presentation in MCTD.
Bhinder
Sumeet
S
University of Mississippi Medical Center, 2500 N State St/ L-525, Jackson, MS 39216, USA. skbhinder@medicine.umsmed.edu
Harbour
Kevin
K
Majithia
Vikas
V
D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000627:therapeutic use; D008947:Mixed Connective Tissue Disease / Q000150:complications*; D009188:Myelitis, Transverse / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use
D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D001379:Azathioprine; D011241:Prednisone; D008775:Methylprednisolone