>I read this and looked this up in medline; for what it's worth. DCJones<
DATE: 1993 Jun
Abstract
Transverse myelitis has been cited as a rare and unusual complication of
systemic lupus erythematosus (SLE). A review of
the literature reveals only 10 cases of transverse myelitis as the
initial presentation of SLE, and only one with reported
benefits from antimalarial therapy. The case of a 30-year-old woman is
reviewed. She presented to the emergency room with
complaints of hypogastric and low back pain. The ensuing course was one
of frank urinary retention and rapidly progressing
quadriparesis. Magnetic resonance imaging of the spine revealed marked
edema of the cervical and thoracic spine. A diagnosis
of SLE was based on positive antinuclear antibodies and leukopenia. The
patient was treated with high dose
methylprednisolone, plasmapheresis and pulse cyclophosphamide for 3
months. Subsequently, treatment was begun with
hydroxychloroquine, and significant improvement in her neurologic and
functional status was achieved after 1 month of therapy.
Ten months after her onset of symptoms, the patient suffered an acute
exacerbation of paraparesis and urinary retention.
Again, she improved clinically after high dose methylprednisolone and
pulse cyclophosphamide for 1 month.
Hydroxychloroquine was continued throughout the duration of therapy.
Klaiman MD Miller SD