Recurrence of Transverse Myelitis after Long Term Neurological Recovery Associated with Antiphospholipid Antibodies in A Patient with Systemic Lupus Erythematosus: A Case Report

Abstract

A 44-year-old female Taiwanese developed T5 transverse myelitis (TM) in 1984, eight years before the diagnosis of systemic lupus erythematosus ( SLE). She responded very well to prednisolone and azathioprine administration and had complete neurological recovery. In August 1997, a relapse of TM at vicinal level, T6, occurred. Magnetic resonance image of teh spinal cord revealed long segment involvement from T 4 to T8. High titer of antiphospholipid antibodies and various serological markers of lupus activity were found to correlate with this relapse of TM. She responded very well to methylprednisolone pulse therapy with nearly complete neurological recovery. Follow-up examination of magnetic resonance imaging, 4 months after relapse, revealed much improvement.Here we report this rare condition in a woman with SLE, who suffered relapse of TM 13 years after a previous episode with complete neurological recovery. A sequential change of antiphospholipid antibodies correlated with LE activities was also presented.