The authors describe a case of a 62-year-old woman with the sudden development of mild paraparesis of the lower extremities with hypaesthesia from dermatome Th5 in a distal direction and with arrest of micturition and defaecation. The laboratory finding revealed a higher ESR and CRP, the immunological examination revealed an elevated value of anti-dsDNA, anti-ssDNA and CIK. As to antiphospholipid antibodies the LA value was elevated, while anticardiolipin antibodies were not found. A number of other examinations incl. radiological ones were made. Magnetic resonance of the spine revealed a hydromyelic cyst in the area Th 3–8. The disease was at the beginning complicated by the development of deep phlebothrombosis of the right lower extremity. After evaluation of all clinical and laboratory results the condition was classified as secondary antiphospholipid syndrome with manifestations of a transverse spinal lesion with acute paraparesis of the lower extremities in conjunction with systemic disease which most probably was systemic lupus erythematosus. Treatment with corticosteroids, immunosuppressives (cyclophosphamide) and anticoagulants (warfarin, anopyrin) led within several months to normalization of the general condition, restoration of urinary excretion and defaecation and substantial regression of the paraparesis of the lower extremities and the ability of independent gait.

        Key words: antiphospholipid syndrome, transverse myelopathy, paraparesis, hydromyelic cyst, systemic lupus erythematosus, immunosuppressive drugs