How do you approach management of patients with lupus and transverse myelitis not responding to pulse dose steroids?  

I consider TM or longitudinal myelitis an emergency. I have been pretty aggressive in my treatment with this diagnosis, and have treated a case with pulse steroids, plex, and Cytoxan with excellent outcomes. The main challenge in such situations is differentiating overlapping MS or other autoimmune ...

In treating transverse myelitis, early aggressive interventions can decrease the long-term neurologic morbidity. If a patient has significant neurologic symptoms, I typically manage with both 5 days of IV methylprednisolone and plasmapheresis. I also perform brain MRI (to evaluate for demyelinating ...

Transverse myelitis is one of the few things we still do pheresis for due to the long-term outcome issues. I would check the AQP4 and MOG antibodies and would give a full NIH 6 months of cytoxan followed by maintenance with CellCept. I have used Rituxan as well as a throw the kitchen sink at them du...