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Abstract Details

SLE presenting with holocord myelitis
Autoimmune Neurology
P9 - Poster Session 9 (12:00 PM-1:00 PM)
15-005
Not applicable

In SLE, neurological symptoms are reported in up to 60% patients but acute myelopathy or lupus transverse myelitis (TM) occurs in only 1-2%. LETM refers to a rare and devastating type of TM that involves at least three contiguous vertebrae on T2-weighted magnetic resonance imaging (MRI). LETM onset is acute and is characterised by severe low back pain, sphincter dysfunction, quadriparesis and sensory-level paraesthesia. The prognosis is generally poor if longer segment is involved as it can lead to prolonged paralysis or even death.

Here we report a rare case of a young woman who presented with acute onset longitudinally extensive transverse myelitis (LETM) extending from medulla to conus as holocord myelitis due to SLE.
Not applicable
Holocord myelitis, a very rare and disabling condition defined as a lesion of the complete spinal cord ;extends from medulla to conus. Here we report a case of a 25-year-old woman, presented with rapidly progressive flaccid quadriparesis. which had  developed over few days, with both bladder and bowel involvement .it was also associated with sensory level and brainstem involvement. She had history of photosensitive rash, joint pain, mild to moderate grade of fever, however she was never evaluated.  Serological markers for systemic lupus erythematosus (SLE) was strongly positive along with magnetic resonance imaging of the spine helped in establishing the diagnosis of SLE-related holocord myelitis. High-dose intravenous glucocorticoid therapy was started followed by intravenous pulse cyclophosphamide.

Bringing this unusual case to light is important as we know that longitudinal myelitis is a rare presentation in SLE itself and while holocord involvement from medulla to conus is exceedingly rare.
Authors/Disclosures

PRESENTER 		No disclosure on file
Mamta B. Singh, MD, MBBS, DM, FÂ鶹´«Ã½Ó³»­ (All India Institute of Medical Sciences) Dr. Singh has nothing to disclose.
Ajay Garg Ajay Garg has nothing to disclose.
Venugopalan Y. Vishnu, MD (All India Institute of Medical Sciences, New Delhi) The institution of Dr. Vishnu has received research support from Department of Health Research.
No disclosure on file
Padma V. Hadakasira, MD (Medwis Healthcare Communications Pvt Ltd) Dr. Hadakasira has nothing to disclose.