Antiphospholipid antibody syndrome presenting as transverse myelitis

Javvid M Dandroo,Firdousa Nabi,Naveed Mohsin

doi:10.4103/1110-161x.168209

Javvid M Dandroo, Firdousa Nabi + Show 1 more

Open Access

https://doi.org/10.4103/1110-161x.168209

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Abstract

The antiphospholipid syndrome (APS) is characterized by arterial and/or venous thrombosis and pregnancy morbidity in the presence of anticardiolipin antibodies and/or lupus anticoagulant. APS can occur either as a primary disorder or secondary to a connective tissue disease, most frequently systemic lupus erythematosus. Central nervous system involvement is one of the most prominent clinical manifestations of APS, and includes arterial and venous thrombotic events, psychiatric features, and a variety of other nonthrombotic neurological syndromes. Although the mechanism of neurological involvement in patients with APS is thought to be thrombotic in origin and endothelial dysfunction associated with antiphospholipid antibodies. APS presenting as acute transverse myelitis is very rarely seen with a prevalence rate of 1%. We are describing a foreigner female presenting as acute transverse myelitis which on evaluation proved to be APS induced. So far, very few cases have been reported in literature with APS as etiology.

Highlights

Transverse myelitis is characterized by acute inflammation affecting a local area of the white matter of the spinal cord usually involving thoracic cord [1]
Patients age at the time of disease onset vary widely, ranging from childhood through the 80s [2].The clinical presentation is characterized by the development of motor neurologic dysfunction, which is associated with sensory abnormalities and abnormalities of the autonomic nerves
Computed tomographic brain was normal and MRI whole spine revealed a lower cervical and upper thoracic cord lesion that enhanced after gadolinium administration, a finding that is consistent with transverse myelitis (Figs. 1 and 2)

Summary

Introduction

Transverse myelitis is characterized by acute inflammation affecting a local area of the white matter of the spinal cord usually involving thoracic cord [1]. Patients age at the time of disease onset vary widely, ranging from childhood through the 80s [2].The clinical presentation is characterized by the development of motor neurologic dysfunction, which is associated with sensory abnormalities (sensory level) and abnormalities of the autonomic nerves (sphincter disturbances). Acute transverse myelitis (ATM) has diverse causes.

Results

Conclusion