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Transverse myelitis in mixed connective tissue disease
Arthritis and Rheumatism
|November 1, 1978
Summary
Severe neurologic complications, like transverse myelitis, can occur in patients with mixed connective tissue disease (MCTD), even if rare. This case highlights potentially devastating neurological outcomes in MCTD patients.
Area of Science:
- Neurology
- Rheumatology
- Immunology
Background:
- Mixed connective tissue disease (MCTD) is an autoimmune disorder with overlapping features of other connective tissue diseases.
- Neurologic manifestations in MCTD are uncommon, typically presenting as mild trigeminal neuralgia.
Observation:
- This report details a rare case of severe transverse myelitis in a patient diagnosed with MCTD.
- The patient presented with progressive areflexic paraplegia and loss of bowel and bladder control.
Findings:
- Neuropathologic examination revealed thoracic cord thinning, widespread axonal and myelin sheath loss, astrocytosis, and macrophage infiltration.
- Vascular changes included thickening and perivascular chronic inflammatory cell infiltration, along with calcium deposits.
Implications:
- This case underscores that severe, therapy-resistant neurologic disease can be a complication of MCTD.
- Highlights the importance of considering severe neurologic involvement in the differential diagnosis of MCTD patients presenting with neurological symptoms.