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

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 sp...

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Bibliographic Details
Published in:	Internal Medicine Vol. 41; no. 2; pp. 156 - 160
Main Authors:	KATO, Yu-ko KIMURA, SEIKO, Yoshihiko, HIRAYAMA, Yoshiyuki, ARAMAKI, Takumi, YAMAGUCHI, Hiroshi, AMANO, Hiroyuki, TAKANO, Teruo
Format:	Journal Article
Language:	English
Published:	Tokyo The Japanese Society of Internal Medicine 2002 Japanese Society of Internal Medicine
Subjects:	Adult Autoimmune Diseases - complications Autoimmune Diseases - drug therapy Autoimmune Diseases - therapy Azathioprine - therapeutic use Biological and medical sciences Brain - pathology Cyclophosphamide - therapeutic use cyclophosphamide pulse therapy Drug Resistance Facial Nerve Diseases - etiology Female Hepatitis, Autoimmune - complications Humans Immunosuppressive Agents - therapeutic use Lupus Erythematosus, Systemic - complications Lupus Erythematosus, Systemic - drug therapy Lupus Erythematosus, Systemic - therapy magnetic resonance angiography Magnetic Resonance Imaging Medical sciences Methylprednisolone - therapeutic use Myelitis, Transverse - drug therapy Myelitis, Transverse - etiology Myelitis, Transverse - pathology Nervous system involvement in other diseases. Miscellaneous Neurology Plasmapheresis Prednisolone - therapeutic use Quadriplegia - etiology Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis Spinal Cord - pathology steroid pulse therapy systemic lupus erythematosus transverse myelitis Urinary Retention - etiology Skin disease Autoimmune disease Methylprednisolone Inflammatory disease Transverse myelitis Systemic disease Complication Lupus erythematosus Diagnosis Disseminated NMR angiography Human Immunopathology Connective tissue disease Corticosteroid Nervous system diseases Nuclear magnetic resonance imaging Plasmapheresis Case study Chemotherapy Cyclophosphamide Oxazaphosphinane derivatives Treatment Nitrogen mustard Central nervous system disease Medical imagery Immunosuppressive agent Spinal cord disease
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Summary:	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)
ISSN:	0918-2918 1349-7235
DOI:	10.2169/internalmedicine.41.156