Banjade Prakash, Bastakoti Sudip, Poudel Ashmita, Sharma Munish
Medicine, Manipal College of Medical Sciences, Pokhara, NPL.
Internal Medicine, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, NPL.
Cureus. 2024 Aug 31;16(8):e68337. doi: 10.7759/cureus.68337. eCollection 2024 Aug.
Longitudinally extensive transverse myelitis (LETM) is a rare but severe neurological complication of systemic lupus erythematosus (SLE). The existing literature contains only limited information about this condition. We present a case of a 38-year-old female with SLE who presented with quadriparesis. Magnetic resonance imaging (MRI) of the brain and spinal cord showed T2-weighted high signal intensity involving the brainstem, bilateral middle and inferior cerebellar peduncles, and C1-C7 spinal cord segments. Early intervention with high-dose methylprednisolone and cyclophosphamide was initiated, resulting in partial clinical recovery. A comprehensive literature review highlights the importance of early diagnosis and treatment, discusses the potential etiologies, and explores the prognostic factors influencing patient outcomes. This case report underscores the need for a high level of clinical suspicion and prompt therapeutic intervention to improve prognosis in SLE patients presenting with LETM.
长节段横贯性脊髓炎(LETM)是系统性红斑狼疮(SLE)一种罕见但严重的神经系统并发症。现有文献对此病症的信息有限。我们报告一例38岁患有SLE的女性患者,该患者出现四肢瘫痪。脑和脊髓的磁共振成像(MRI)显示T2加权高信号累及脑干、双侧小脑下脚和中脚以及C1 - C7脊髓节段。开始采用大剂量甲泼尼龙和环磷酰胺进行早期干预,临床症状部分恢复。全面的文献综述强调了早期诊断和治疗的重要性,讨论了潜在病因,并探讨了影响患者预后的因素。本病例报告强调,对于出现LETM的SLE患者,需要高度的临床怀疑和及时的治疗干预以改善预后。