Acute longitudinally extensive transverse myelitis: A case report

Introduction: Acute Longitudinally Extensive Transverse Myelitis (ALETM) poses a problem of etiological diagnosis. The etiologies are diverse; infectious, degenerative, inflammatory and auto-immune. Case report: We are presenting the case of a 19 years old patient, with no prior medical history. He presented with acute flaccid paraplegia, urinary retention and fecal incontinence. The magnetic resonance imaging concluded to ALETM and the etiological investigation allowed us to confirm the diagnosis of myelitis inaugurating systemic lupus erythematosus. The treatment was based on the association of corticoids, cyclophosphamides and four plasma exchanges. No real improvement in the neurological deficiency was noted. Conclusion: The lupus origin of ALETM, although rare, should be considered in young patients since it could, as in our case, the diagnostic circumstance of systemic lupus erythematosus.