Severe Transverse Myelitis Following Ankle Surgery Potentially Unmasking Late-Onset Systemic Lupus Erythematosus

Cureus, 2024 · DOI: 10.7759/cureus.74006 · Published: November 19, 2024

Simple Explanation

A 70-year-old female experienced sudden neurological symptoms after ankle surgery, including thigh paresthesias and back pain. The patient's condition worsened, leading to lower extremity weakness, numbness, urinary retention, and constipation. Treatment with methylprednisolone and IVIG improved the patient's strength and sensation, and further testing revealed a potential diagnosis of lupus myelitis.

Study Duration

Not specified

Participants

One 70-year-old female

Evidence Level

Case Report

Key Findings

1
The patient presented with transverse myelitis symptoms after ankle surgery, which is an unusual presentation.
2
The patient's positive response to methylprednisolone suggested an autoimmune etiology, leading to the discovery of SLE.
3
The case highlights the importance of considering immune-mediated disorders in the differential diagnosis of spinal cord injuries, even post-operatively.

Research Summary

This case report describes a 70-year-old female who developed severe transverse myelitis following ankle surgery. The transverse myelitis was potentially unmasking late-onset systemic lupus erythematosus (SLE). Prompt treatment with corticosteroids should be considered in cases of suspected immune-mediated spinal cord disorders.

Practical Implications

Diagnostic Consideration

Consider autoimmune etiologies like SLE in patients presenting with transverse myelitis, especially if symptoms arise post-operatively.

Treatment Approach

Promptly initiate corticosteroid treatment in suspected immune-mediated spinal cord disorders, pending diagnostic confirmation.

Further Research

Further studies are needed to investigate the optimal treatment strategies for transverse myelitis and the role of corticosteroids in spinal cord injuries.

Study Limitations

1
Single case report limits generalizability.
2
Lack of large studies on corticosteroid treatment for spinal cord injuries.
3
Unclear if transverse myelitis was directly related to the ankle surgery or purely coincidental.

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