全身性エリテマトーデスと急性横断性脊髄炎：稀な関連性に関する症例報告

Acute transverse myelitis is a rare neurological complication of systemic lupus erythematosus (SLE), particularly in sub-Saharan African origin patients. We report a case of acute transverse myelitis in a sub-Saharan African origin patient with SLE. This case involved a 37-year-old female patient with SLE and secondary Sjögren's syndrome, presenting with progressively worsening paraplegia. Examination revealed paraplegia of the lower limbs and paraparesis of the upper limbs. Lumbar puncture yielded clear cerebrospinal fluid with hyperproteinorachia. Spinal magnetic resonance imaging showed transverse myelitis in lumbar level; the 24-hour proteinuria was 4.2 g. The diagnosis of acute transverse myelitis and renal flare of SLE was made. Clinical improvement was achieved with methylprednisolone, cyclophosphamide, and physiotherapy. Acute transverse myelitis remains a rare and poorly understood complication of lupus, characterized by its severity and very poor prognosis.