title: Systemic lupus erythematosus presented as extensive longitudinal myelitis.
abstract: BACKGROUND
  longitudinal myelitis (LM) is defined by the continuous lesion of more than four spinal cord segments. LM is a rare variant of acute transverse myelitis and it frequently presented poor responses to immunomodulatory therapy, which resulted in severe and disabling sequelae. We reported a case of acute longitudinal myelitis involving extensive lesions from cervical spinal cord to conus medullaris caused by newly diagnosed SLE.
  
  
  METHODS
  A 39 years old man who was previously healthy presented to our hospital due to acute urinary retention with progressive lower limb weakness for a week. Brisk deep tendon reflexes in upper limbs and decreased reflexes in lower limbs were noted on admission. The pin-prick, vibration, and light touch sensations were decreased in the lower limbs. Spinal MRI sagittal view showed an T2WI bright up mass in the spinal cord below C3/4 level with extension to conus medullaris. He was diagnosed SLE based on ARA criteria. After ruling out mimics including NMO and MS, SLE with LM explained what happened to him .
  
  
  CONCLUSIONS
  Given the poor prognosis of SLE with LM, which resulted in severe and disabling sequelae. More comprehensive understand of the disease course, real mechanisms and treatment strategy are needed.
authors.affiliation: Department of Neurological, Department, Shuang-Ho Hospital, Taipei Medical University.
authors.forename: Li-Kai
authors.initials: LK
authors.lastname: Huang
authors.forename: Chen-Chih
authors.initials: CC
authors.lastname: Chung
authors.forename: Bo-Zhi
authors.initials: BZ
authors.lastname: Chen
authors.forename: Nai-Fang
authors.initials: NF
authors.lastname: Chi
authors.forename: Chaur-Jong
authors.initials: CJ
authors.lastname: Hu
mesh_terms: D000328:Adult; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D009187:Myelitis / Q000150:complications* / Q000473:pathology*; D013116:Spinal Cord / Q000473:pathology*