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KMID : 0604620060130020097
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Dongguk Journal of Medicine
2006 Volume.13 No. 2 p.97 ~ p.102
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A Case of Longitudinal Myelitis Associated with Systemic Lupus Erythematosus
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Park Jin-Woo
Choe Seung-Won
Woo Soon-Joo
Jo Joon-Hyun
Lee Gi-Young
Eum Eun-A
Chung Hyun-Chul
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Abstract
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Transverse myelitis (TM) is a clinical syndrome in which an immune-mediated process causes neural injury of the spinal cord, resulting in sensory or motor deficits and sphincter dysfunction. It is a rare and serious complication of systemic lupus erythematosus (SLE). TM may involve continuous levels of the spinal cord, recently named ’longitudinal myelitis’ is more unusual and shows generally poor prognosis. Magnetic resonance imaging (MRI) typically reveals the increased signal intensity in T2 weighted images and edema of the spinal cord. We describe a 24-year-old woman with SLE who developed longitudinal myelitis with acute catastrophic onset, manifesting as quadriparesis, respiratory failure, and sphincter dysfunction. MRI showed extensive involvement of the spinal cord from T5 to T12, medial thalamus, mid brain, pons, and cerebellum. She responded partially to the treatment with high dose corticosteroid, plasmapheresis and cyclophosphamide. But the flaccid paralysis of the lower extremities, sensory loss below T10 levels, and neurogenic bladder persisted.
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KEYWORD
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systemic lupus erythematosus, myelitis, cyclophosphamide, plasmapheresis
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