Longitudinal myelitis in a patient with systemic lupus erythematosus - a rare case report

Transverse myelitis is a rare but serious neurological complication of systemic lupus erythematosus (SLE). A longitudinal involvement of the spinal cord with lupus related transverse myelitis is even more unusual. We report the case of a 27-year-old woman who had a catastrophic onset of paraplegia within two days of diagnosis of SLE. Magnetic resonance imaging of the spine established the diagnosis of longitudinal myelitis extending from C6-L1 level. Despite early aggressive treatment with combination of methylprednisolone and cyclophosphamide pulse therapies, her condition did not improve till 4 months of follow-up. Her case is peculiar because longitudinal myelitis involving almost the entire spinal cord is exceedingly rare.