Lupus Myelitis

Types:

(1) transverse

(2) longitudinal

Risk factors:

(1) antiphospholipid antibodies (for longitudinal myelitis)

(2) active disease (but can occur with mild)

Clinical findings:

(1) sensory deficit

(2) variable motor deficit, including paraplegia

(3) urinary sphincter dysfunction

(4) altered reflexes

Laboratory findings:

(1) elevated CSF protein concentration

(2) variable oligoclonal bands on immuno-electropheresis on the CSF

(3) elevated serum ESR and/or C-reactive protein

Imaging studies (T2-weighted MRI) are important for determining the extent of the disease. It is important for recognizing longitudinal myelitis.

Early and aggressive immunosuppressive therapy is associated with a favorable outcome. Severe neurological findings, low muscle strength and delayed therapy can result in an unfavorable outcome.