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Amir M. Torabi, MD; Rahul K. Patel, MD; Gil I. Wolfe, MD; Charlece S. Hughes, DO; Dianne B. Mendelsohn, MD; Jaya R. Trivedi, MD

Arch Neurol. 2004;61:126-128.

Background  Neurological involvement occurs rarely with systemic sclerosis (SSc). Only a few cases of transverse myelopathy have been reported in the setting of SSc.

Objective  To describe a patient with SSc who developed transverse myelitis that improved during a course of immunosuppression.

Results  A 30-year-old woman with SSc presented with subacute onset of bilateral lower extremity weakness and numbness. Results of magnetic resonance imaging and cerebrospinal fluid studies supported a diagnosis of transverse myelitis. The patient responded favorably to a course of corticosteroids and cyclophosphamide. No overlapping autoimmune disorders were evident. Clinical follow-up showed significant recovery, with resolution of radiological abnormalities.

Conclusion  Transverse myelitis can occur as a rare manifestation of SSc and may respond favorably to immunosuppressive therapy.

From the Departments of Neurology (Drs Torabi, Wolfe, Hughes, and Trivedi), Rheumatology (Dr Patel), and Radiology (Dr Mendelsohn), The University of Texas Southwestern Medical Center at Dallas.