Development of Severe Longitudinal Atrophy of Thoracic Spinal Cord Following Lupus-Related Myelitis.

Abstract

A 26-year-old womansuffered from acute myelitis at Th 6 level associated with systemic lupus erythematosus. Methyl-prednisolone pulse therapy, intravenous high-dose immunoglobulinadministration and plasmapheresis were not effective. Her neurological signs had persisted in spite of subsequent administration of oral prednisolone and azathiopurine. Magnetic resonance imaging (MRI) of spinal cord at the onset showed a marked swelling with intramedullary high intensity signals on T2WI along the whole thoracic cord. Three years later, MRIdemonstrated a severe longitudinal and segmental atrophy of the mid to low thoracic cord which resulted in transverse spinal signs. (Internal Medicine 40: 353-357, 2001)

A case of systemic lupus erythematosus presenting transverse myelitis after an episode of meningitis

“…24 Schantz et al 17 speculated the possibility that antiphospholipid antibodies might develop chronic and longitudinal cord atrophy. In contrast, other reports 14,18 did not support this observation. Anti-SS-A antibodies were also reported to be associated with TM.…”

“…Resolution of the MRI findings and results of the CSF analysis, as well as normal findings of the brain MRI and clinical course, were all compatible with SLE-related TM. [16][17][18][19] In our case, the patient developed TM 7 years after the onset of SLE. Transverse myelitis has been described as a late complication of SLE, 5 but a contradictory report has also been found.…”

“…Transverse myelitis has been described as a late complication of SLE, 5 but a contradictory report has also been found. 14 Several reports 10,[17][18][19] suggested that TM appears when SLE is clinically or serologically active. In our case, we considered that transverse myelitis developed when SLE was serologically becoming active.…”

Successful High Dose Glucocorticoid Treatment for Subacute Neuromyelitis Optica with Systemic Lupus Erythematosus

“…Especially in the present case, the high intense signal on T2-weighted images tended to parallel the effect of glucocorticoid treatment. Even for patients in remission, we should radiologically examine atrophy or cavitation of the spinal cord and optic nerve as further late complications (13,17). …”

Longitudinal extensive transverse myelitis: a rare neurological complication of systemic lupus erythematosus

“…Longitudinal extensive transverse myelitis (LETM) is a rare variant of myelitis and is defined as the involvement of more than three to four continuous spinal segments 2. There are very few case reports of LETM associated with SLE 3–158 10.…”