Non-Compressive Myelopathy Secondary to Triple Antibody-Positive Primary Antiphospholipid Syndrome

Transverse myelitis is a rare neurological manifestation of antiphospholipid antibody syndrome. Most previously reported cases present with an acute or subacute onset whereas chronic presentations are extremely rare and pose a significant diagnostic challenge. We report a case of middle-aged female with a prior history of unprovoked deep vein thrombosis of the right lower limb who presented with gradually progressive symptoms suggestive of non-compressive cervical myelopathy. Blood investigations revealed a triple-positive antiphospholipid antibodies profile with no clinical or immunological evidence of the commonly associated systemic lupus erythematosus SLE. She was treated with high-dose steroids and mycophenolate mofetil and demonstrated mild to moderate clinical improvement after six months of follow-up.