Transverse myelopathy is a rare complication of mixed connective tissue disease (MCTD). To date there have been relatively few reports, all in females.1-6 We describe a case of transverse myelopathy in a man with MCTD and review the previous cases, comparing them with transverse myelopathy related to systemic lupus erythematosus (SLE).

A 46 year old man with a history of a squamous cell carcinoma of his right upper lobe bronchus and a 2 year history of MCTD was admitted to hospital with a 3 month history of subacute progressive lower limb weakness, sensory loss, and sphincter disturbance. He had been diagnosed with MCTD on the basis of Raynaud's phenomenon, polyarthralgia, synovitis, acrosclerosis, raised muscle enzymes, biopsy established myositis, dysphagia for solids, positive test for antinuclear factor (ANF) (speck1ed 1/2560), negative DNA binding, and high titre antiribonuclear protein (anti-RNP). His bronchial carcinoma had been treated surgically with a right pneumonectomy and radiotherapy to the bronchial stump at a low dose of 3000 cgrad over 10 days. No lymph node involvement was identified either at operation or on CT. He had recently been prescribed a reducing course of prednisolone for active myositis. There was …