Transverse myelitis in systemic lupus erythematosus--the effect of IV pulse methylprednisolone and cyclophosphamide.

Transverse myelitis is a rare but serious complication of systemic lupus erythematosus (SLE). Standard treatment with medium to high doses of oral prednisone has been inadequate to control neurologic sequelae, and patients remain confined to a wheel chair or even die. We employed aggressive treatment in 7 patients with transverse myelitis complicating SLE with pulse methylprednisolone for acute episodes followed by pulse cyclophosphamide for a mean of 6 months; most of our patients are currently able to walk and have partial or total sphincter control.