[Recurrent acute transverse myelopathy: an 83-year-old man with antiphospholipid syndrome]

We reported here an 83-year-old man with recurrent acute transverse myelopathy probably due to antiphospholipid syndrome (APS). The patient was admitted to a local hospital on May 8, 1996, because of hypoesthesia and muscle weakness of both legs, accompanied by dysuria. T2-weighted magnetic resonance image (MRI) showed significant swelling and increased intensity of the thoracic spinal cord between Th3 and Th7 without enhancement by contrast medium. After the treatment with steroid, both clinical symptoms and abnormal findings on MR imaging disappeared. On 24 June, however, motor paralysis of both legs and sensory loss below the chest relapsed. The lesion in the thoracic spinal cord between Th4 and Th8 reappeared on T2-weighted MRI. Blood examination disclosed the presence of a lupus anticoagulant. Repeated examinations of CSF revealed the continuous elevation of IgG. Clinical and laboratory findings indicated that immunological mechanisms related with APS might be responsible for the transverse myelopathy in this patient.