J Korean Rheum Assoc.  2005 Dec;12(4):341-346.

Longitudinal Myelitis in the Cervical Cord Presenting Weakness of the Lower Extremities, as an Initial Manifestation of SLE

Affiliations
  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. yongbpark@yumc.yonsei.ac.kr
  • 2Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.

Abstract

Transverse myelitis is a rare and serious complication of systemic lupus erythematosus (SLE). Magnetic resonance imaging (MRI) shows cord swelling and increased signal intensity in T2-weighted images in a patient with transverse myelitis. We described a 45-year-old man presenting with weakness on the lower extremities without involvement of the upper extremities, as an initial manifestation of SLE. The lesion was involved continuous levels of the cervical spinal cord, a distinctive feature recently named 'longitudinal myelitis'. His symptoms and signs responded well to the cyclophosphamide and methylprednisolone pulse therapies. So far, 10 cases of longitudinal myelitis have been reported in the world. But only 2 cases presented lower extremities weakness rather than upper extremities, in spite of cervical spine involvement. We report a patient with longitudinal myelitis in the cervical cord presenting weakness of the lower extremities as an initial manifestation of SLE with literature review.

Keyword

Longitudinal myelitis; Systemic lupus erythematosus

MeSH Terms

Cyclophosphamide
Humans
Lower Extremity*
Lupus Erythematosus, Systemic
Magnetic Resonance Imaging
Methylprednisolone
Middle Aged
Myelitis*
Myelitis, Transverse
Spinal Cord
Spine
Upper Extremity
Cyclophosphamide
Methylprednisolone
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