Lupus myelopathy

Pract Neurol. 2018 Feb;18(1):66-69. doi: 10.1136/practneurol-2017-001756. Epub 2017 Nov 2.


Although neurological manifestations of systemic lupus erythematosus (SLE) are well recognised, myelopathy complicating SLE is rare. A 35-year-old woman presented with non-specific symptoms and a respiratory tract infection but had serological evidence of SLE. She subsequently deteriorated rapidly, developing a catastrophic spinal cord syndrome. Her initial MRI was normal; but after 1 month, her encephalopathy having progressed, repeat imaging showed characteristic myelitic changes. She responded only slowly to a combination of cyclophosphamide and corticosteroids. This case exemplifies the mixed presentations of SLE, including the under-recognised 'subpial leukomyelopathy' of central nervous system lupus. It highlights the challenges in managing lupus-related myelopathy and the benefits of a multidisciplinary approach to care.

Keywords: myelopathy; neuroimmunology; neuropharmacology; rheumatology; sle.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Complement C3 / metabolism
  • Complement C4 / metabolism
  • Female
  • Granulocyte Colony-Stimulating Factor / metabolism
  • Humans
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / diagnostic imaging
  • Lupus Erythematosus, Systemic / drug therapy
  • Magnetic Resonance Imaging
  • Spinal Cord / diagnostic imaging
  • Spinal Cord Diseases / diagnostic imaging
  • Spinal Cord Diseases / etiology*


  • Adrenal Cortex Hormones
  • Complement C3
  • Complement C4
  • Granulocyte Colony-Stimulating Factor