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A Unique Case Report of Recovery After Longitudinal Myelitis Related to Lupus

Jackson, Steven D. MD; Wiering, Bethany A. BA; Bentley, Ingrid A. PT; Herrmann, Amanda A. PhD; Hanson, Leah R. PhD

American Journal of Physical Medicine & Rehabilitation: October 2019 - Volume 98 - Issue 10 - p e119–e122
doi: 10.1097/PHM.0000000000001117
Case Report
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Longitudinal myelitis secondary to an acute flare of systemic lupus erythematosus has been reported in the literature. There have been few published cases of complete functional recovery in patients with systemic lupus erythematosus–related longitudinal myelitis (systemic lupus erythematosus–related longitudinal myelitis). Of those cases, none have described in detail the rehabilitation course of treatment. In the current case, intensive rehabilitation was coupled with aggressive pharmaceutical treatment resulting in almost full functional recovery. A 23-yr-old African American woman with a history of systemic lupus erythematosus was originally admitted as an inpatient for flank pain. Overnight, she progressed rapidly to complete flaccid paraplegia classified as T3 American Spinal Injury Association Impairment Scale A based on the International Standards for Neurological Classification of Spinal Cord Injury. Throughout the next year, she participated in acute inpatient rehabilitation, followed by outpatient rehabilitation (physical, occupational, and aquatic therapies). A year after her initial hospital admission, she progressed to full community ambulation T3 American Spinal Injury Association Impairment Scale D. This case illustrates the importance of proper medical treatment and a comprehensive rehabilitation program, which improved functional outcomes for a patient with a complete spinal cord injury due to systemic lupus erythematosus–related longitudinal myelitis.

From the HealthPartners Neuroscience Center, St. Paul, Minnesota (SDJ, BAW, IAB, AAH, LRH); Regions Hospital, St. Paul, Minnesota (SDJ, IAB); and HealthPartners Institute, Minneapolis, Minnesota (BAW, AAH, LRH).

All correspondence should be addressed to: Steven D. Jackson, MD, HealthPartners Neuroscience Center, 295 Phalen Blvd, MS 41200A, St. Paul, MN 55130.

This study was funded by the Research, Education, and Development fund through Regions Hospital, St. Paul, MN.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.ajpmr.com).

Online date: December 15, 2018

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