Sánchez BM, Vásquez CJ

Language: Spanish
References: 9
Page: 1-5
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ABSTRACT

A 30 years-old woman with chronic depression and Systemic Lupus Erythematosus since one month ago, who presented a 2 days history of progressive lower limbs weakness and afterward developed paresthesia, flaccid paraplegia, bladder atonia with urinary retention and constipation. Physical examination disclosed right sixth cranial nerve palsy with horizontal diplopia and nystagmus, absent deep tendon reflexes in the lower extremities, sphincter dysfunction and sensory level at T6. Transverse myelitis was suspected and patient was treated with intravenous pulses steroids, monthly pulses cyclophosphamide and apheresis with symptoms improve. Spinal cord MRI was performed and showed hyperintense diffuse lesions in the T2 weighted images with longitudinal involvement from the spinal distal third to connus medullaris compatible with longitudinally extensive transverse myelitis (LETM). Patient was discharged from ICU with clinical improvement and monthly cyclophosphamide was continued. At present, she persists with saddle hypoesthesia and uses a walking cane without difficulty. We report one case of acute LETM, just a few cases has been reported in world literature.

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