CASE REPORT
Catastrophic transverse myelitis in a patient with systemic lupus erythematosus
Futoshi Yamanaka1, Kiyoshi Migita2 , Katsuhiro Ichinose1, Naoyoshi Ohno1, Hironori Kimura1, Hideki Ishimaru3, Yojiro Matsuoka3, Katsumi Eguchi4 and Hironori Ezaki1
| (1) |
Department of General Internal Medicine and Neurology, National Nagasaki Medical Center, Nagasaki, Japan |
| (2) |
Clinical Research Center, National Nagasaki Medical Center, 2-1001-1 Kubara, Omura, Nagasaki 856-8562, Japan |
| (3) |
Department of Radiology, National Nagasaki Medical Center, Nagasaki, Japan |
| (4) |
First Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan |
Received: 27 July 2004 Accepted: 06 December 2004
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Abstract A 24-year-old Japanese woman was admitted to our hospital suffering from high fever and progressive paralysis in both legs. Magnetic resonance imaging of the spinal cord showed high-intensity signals from C5 to Th4 and from Th7 to L1 on T2-weighted images. The patient was diagnosed as having acute transverse myelitisTM, which was a complication of systemic lupus erythematosus based on the serological findings. Despite aggressive immunosuppressive treatments including corticosteroid pulse therapy, plasmapheresis, and intravenous cyclophosphamide, the paralysis of her lower extremities did not improve. In the catastrophic type of lupus-associated TM, which develops extensively and longitudinally along the spinal cord, the prognosis still seems to be poor despite intensive treatments.
Key words Intravenous cyclophosphamide (IV-CY) - Systemic lupus erythematosus (SLE) - Transverse myelitis (TM)
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