SYSTEMIC LUPUS-ERYTHEMATOSUS ASSOCIATED WITH TRANSVERSE MYELITIS AND PARKINSONIAN SYMPTOMS

A 31-year old woman developed transverse myelitis after 10 years remis sion since she was first diagnosed as systemic lupus erythematosus. Al though pulse methyl prednisolone resolved her myelitis, Parkinson-like symptoms developed subsequently after reduction of steroid. Treatment s including apheresis did not improve her Parkinson-like symptoms such as rigidity, akinesia, impairment of speech and mask-like facial expr ession. Levodopa was effective as a symptomatic therapy. Orally admini stered cyclophosphamide eventually led her to remission and withdrawal from levodopa. Her clinical course and the absence of other possible causes prompted us to conclude that Parkinsonian symptoms as well as t ransverse myelitis may have developed as manifestations of central ner vous system lupus.