Longitudinal myelitis in a patient with systemic lupus erythematosus.

Longitudinal myelitis is an exceedingly rare complication of systemic lupus erythematosus (SLE), of which only 11 cases have been published so far. We report a case in a 65-year-old woman in whom spinal cord dysfunction developed over several weeks, resulting in tetraparesis. She had a known history of SLE with a circulating anticoagulant. Magnetic resonance imaging of the spine and a stereotactic biopsy of a brain lesion established the diagnosis of SLE-related longitudinal myelitis. High-dose glucocorticoid therapy had started to bring about an improvement when she experienced a series of complications that were eventually fatal. Her case is unusual in that longitudinal myelitis is exceedingly rare in patients with SLE.