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

Jackson, Steven D., MD1,3; Wiering, Bethany A., BA1,2; Bentley, Ingrid A., PT1,3; Herrmann, Amanda A., PhD1,2; Hanson, Leah R., PhD1,2

American Journal of Physical Medicine & Rehabilitation: December 14, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHM.0000000000001117
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Longitudinal myelitis secondary to an acute flare of systemic lupus erythematosus (SLE) 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 (SLE-LM). 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-year-old African-American woman with a history of SLE was originally admitted as an inpatient for flank pain. Overnight, she progressed rapidly to complete flaccid paraplegia classified as T3 AIS A (AIS = American Spinal Injury Association Impairment Scale) based on the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). 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 AIS 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 SLE-LM.

1HealthPartners Neuroscience Center, St. Paul, MN, USA

2HealthPartners Institute, Minneapolis, MN, USA

3Regions Hospital, St. Paul, MN, USA

Correspondence: Steven D. Jackson, MD, HealthPartners Neuroscience Center, 295 Phalen Blvd. MS 41200A, St. Paul, MN 55130. Tel: (651) 495-6565; Fax: (651) 495-6375. Email: Steven.D.Jackson@HealthPartners.com

Author Disclosures: This project was funded by the Research, Education, and Development fund through Regions Hospital, St. Paul, MN. The authors declare no conflicts of interest related to this manuscript.

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