Marked inflammation in catastrophic longitudinal myelitis associated with systemic lupus erythematosus

Lupus. 2007;16(10):823-6. doi: 10.1177/0961203307081846.


Catastrophic longitudinal myelitis is an extremely rare neurologic manifestation of collagen vascular disease, described heretofore in 11 cases of SLE and 1 of Sjogren's Syndrome. This report documents markedly abnormal and worsening CSF findings on sequential CSF examinations over a period of three days (WBC >1500 cells/microL, >80% neutrophils, markedly elevated protein, and extremely low glucose levels) in the absence of infection. These abnormalities cleared rapidly with institution of immunosuppressive therapy so that a third CSF exam done within three days revealed almost complete normalization of CSF values. These findings suggest that in some cases of CLM a strong inflammatory component may be present, while in others, other pathogenic factors may predominate.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cerebrospinal Fluid / chemistry
  • Cerebrospinal Fluid / cytology
  • Cerebrospinal Fluid Proteins / analysis
  • Humans
  • Inflammation / etiology*
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / pathology
  • Male
  • Myelitis / diagnosis
  • Myelitis / pathology*
  • Nervous System Diseases
  • Vascular Diseases


  • Cerebrospinal Fluid Proteins