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
Full
Text (PDF)
| (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
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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