Transverse myelitis as the presentation of Jo-1 antibody syndrome (myositis and fibrosing alveolitis) in long-standing ulcerative colitis.
Ray DW., Bridger J., Hawnaur J., Waldek S., Bernstein RM., Dornan TL.
A 32-yr-old woman with long-standing ulcerative colitis developed paraesthesiae, sensory loss and muscle weakness shown by magnetic resonance scan to be due to transverse myelitis in the cervical spinal cord. More than 12 months later, she developed dermatomyositis and fibrosing alveolitis and was found to have the Jo-1 antibody. Her condition worsened despite high dose oral prednisolone but improved following intravenous methylprednisolone, immunosuppressive therapy and plasma exchange. This is the first reported case of a neurological presentation of the Jo-1 antibody syndrome. We speculate that the association with ulcerative colitis may have been causal rather than coincidental and suggest that plasma exchange should be considered together with aggressive immunosuppression in seriously ill patients with this disease.