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Iatrogenic transverse myelitis in a patient with rheumatoid arthritis
  1. Pournamy Sarathchandran1,
  2. Ayman Alboudi2,
  3. Reem AlSuwaidi2 and
  4. Abubaker AbdulRahman Almadani3
  1. 1 Department of Neurology, Rashid Hospital, Dubai, United Arab Emirates
  2. 2 Rashid Hospital, Dubai, United Arab Emirates
  3. 3 Department of Neurology, DHA, Dubai, United Arab Emirates
  1. Correspondence to Dr Pournamy Sarathchandran, pournamydr{at}


We report the case of a 59-year-old Arab woman who was presented with acute onset of neck pain followed by quadriparesis, paraesthesias of lower limbs and incontinence of urine. Examination revealed asymmetric sensorimotor quadriparesis with sensory level at T1, establishing a clinical diagnosis of transverse myelitis. Cervical and thoracic spinal MRI showed enhancing T2/fluid attenuated inversion recovery (FLAIR) hyperintense lesion extending from C4 to C7 level in addition to long-segment lesion extending the whole of the spinal cord. She was known to have rheumatoid arthritis for the past 20 years and has been on etanercept for the past 8 years and methotrexate since past 3 years. Etanercept was stopped and she was treated with methylprednisolone followed by oral steroids and physiotherapy with which she had near complete recovery.

  • rheumatoid arthritis
  • unwanted effects / adverse reactions

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  • Contributors PS conceived the idea of writing the case report and formulated it. AA reviewed literature, helped selecting the figures and helped formulating the draft. RA reviewed the literature and modified the draft. AARA reviewed the case report and added to the literature review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.