Raffaele Nardone1, Ryan T Fitzgerald2, Ariel Bailey3, Giulio Zuccoli4. 1. Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria; Department of Neurology, Franz Tappeiner Hospital, Merano, Italy. 2. Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. 3. Department of Radiology, Children's Hospital of Pittsburgh at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. 4. Department of Radiology, Children's Hospital of Pittsburgh at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. Electronic address: giulio.zuccoli@gmail.com.
Abstract
OBJECTIVE: To report a case of longitudinally extensive transverse myelitis (LETM), a rare but disabling condition defined as a lesion of the spinal cord that extends over four or more vertebrae on MRI, in association with systemic lupus erythematosus (SLE). METHODS: We present a rare case of LETM involving the cervical and thoracic spinal cord in a patient with SLE and review the existing literature on the association of lupus-associated myelitis. RESULTS: LETM is included within the diagnostic criteria for Neuromyelitis Optica (NMO), but is also known to be associated with a wide range of auto-immune diseases. Only 37 cases of LETM in patients with SLE have been previously described. We performed an updated review on epidemiology, pathophysiology, clinical features, diagnosis, management, and prognosis of LETM in the setting of SLE. CONCLUSION: Due to the generally poor prognosis of LETM in SLE patients, prompt diagnosis and treatment is of critical importance for a positive clinical outcome. We provide a comprehensive perspective of past and current literature in order to aid diagnosis and management of this rare phenomenon.
OBJECTIVE: To report a case of longitudinally extensive transverse myelitis (LETM), a rare but disabling condition defined as a lesion of the spinal cord that extends over four or more vertebrae on MRI, in association with systemic lupus erythematosus (SLE). METHODS: We present a rare case of LETM involving the cervical and thoracic spinal cord in a patient with SLE and review the existing literature on the association of lupus-associated myelitis. RESULTS: LETM is included within the diagnostic criteria for Neuromyelitis Optica (NMO), but is also known to be associated with a wide range of auto-immune diseases. Only 37 cases of LETM in patients with SLE have been previously described. We performed an updated review on epidemiology, pathophysiology, clinical features, diagnosis, management, and prognosis of LETM in the setting of SLE. CONCLUSION: Due to the generally poor prognosis of LETM in SLEpatients, prompt diagnosis and treatment is of critical importance for a positive clinical outcome. We provide a comprehensive perspective of past and current literature in order to aid diagnosis and management of this rare phenomenon.
Authors: Talha Mehmood; Irsa Munir; Madina Abduraimova; Miguel Antonio Ramirez; Sunny Paghdal; Isabel M McFarlane Journal: Am J Med Case Rep Date: 2019-07-31