Longitudinal transverse myelitis as a clinical manifestation of Neuropsychiatric Systemic Lupus Erythematosus

Abstract

Case presentation. A 22-year-old woman with a history of systemic lupus erythematosus, depression and epilepsy, allergic to hydroxychloroquine, who consulted for diarrhea, arthralgias, eyelid oedema, retro auricular pain and odynophagia. She was hospitalized for an infectious condition but requested voluntary discharge on the third day. She consulted again a week later with symptoms of ascending paraparesis, dysphagia, difficulty in urination and defecation, purplish macules on the legs, continuous fever, disorientation and psychomotor agitation. Treatment. She was admitted to the critical care unit. Cerebrospinal fluid, nerve conduction velocity (severe acute axonal motor polyneuropathy), and magnetic resonance imaging compatible with longitudinal myelitis were performed. Outcome. The patient was hospitalized for 140 days. Her evolution was monitored and physiotherapy and training for her relatives was coordinated for three days before her discharge from hospital. One month after home care, the patient was readmitted to hospital with sepsis of urinary origin and died.