Key result
Treatment with intravenous methylprednisolone and cyclophosphamide led to remarkable clinical recovery of visual acuity and muscle strength in a patient with SLE and influenza-induced transverse myelitis.
Why the study?
Transverse myelitis is a rare complication in patients with systemic lupus erythematosus, and viral infections may trigger it by dysregulating the immune system.
Case Report (n=1)
Viral infections like influenza A can induce transverse myelitis in patients with SLE, which may respond well to prompt immunosuppressive therapy.
Influenza A may trigger TM in SLE; this Level 5 case is hypothesis-generating and leaves the association open.
Transverse myelitis (TM) is a rare complication seen in 1-2% of patients with systemic lupus erythematosus (SLE). Viral infections may cause TM in these patients by causing a dysregulation of their immune system. We report a 30-year-old woman with SLE who had influenza A and a few days later developed urinary retention, bilateral lower extremity paralysis, upper extremity weakness, and optic nerve and macular edema. Magnetic resonance imaging showed C4-T12 hyperintense lesions consistent with TM. She was treated with intravenous methylprednisolone 1 g daily for 3 days and then 6 cycles of monthly intravenous cyclophosphamide. This treatment was followed by oral prednisone. She had a remarkable clinical response. Visual acuity improved to her baseline, and muscle strength almost fully recovered. Clinicians should be aware that viral infections, including influenza, may induce TM. This case highlights the importance of early recognition and prompt treatment with immunosuppressive drugs in such cases.
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Márquez et al. (2022) conducted a case report in Transverse myelitis in systemic lupus erythematosus after influenza A infection (n=1). Intravenous methylprednisolone and cyclophosphamide was evaluated on Clinical response (visual acuity and muscle strength). Treatment with intravenous methylprednisolone and cyclophosphamide led to remarkable clinical recovery of visual acuity and muscle strength in a patient with SLE and influenza-induced transverse myelitis.
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