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To the Editor:
We read with interest the recent article in Neurology regarding the usefulness of adding plasma exchange (PLEX), cyclophosphamide (CP), or both to a course of IV methylprednisolone in patients with transverse myelitis (TM).1
The authors concluded that in patients with TM who have ASIA A disability, combination of PLEX and CP showed benefit. In patients without ASIA A level of disability, PLEX (and not CP) provided benefit beyond steroids. We would like to make some specific points.
Greenberg et al. proposed to study the efficacy of immunotherapy in patients with “idiopathic” TM yet they have included patients with autoimmune diseases. Presence of connective tissue diseases is an exclusion criterion for a diagnosis of idiopathic TM.2
There is no information …
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