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2016 ; 2
(ä): 16005
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Myelitis in systemic lupus erythematosus: clinical features, immunological
profile and magnetic resonance imaging of five cases
#MMPMID28053749
Hryb JP
; Chiganer E
; Contentti EC
; Di Pace JL
; Lessa C
; Perassolo MB
Spinal Cord Ser Cases
2016[]; 2
(ä): 16005
PMID28053749
show ga
Myelopathy is one of the neuropsychiatric lupus syndromes. In this article, an
original series of related lupus myelitis is reported and analyzed. We employed a
retrospective chart review and identified all patients who were admitted to a
general hospital in Buenos Aires, Argentina, with SLE and myelitis during the
period 2007-2014. Five patients were observed, all women. The mean age was 25.4
years (19-39). In three of five cases, myelitis was one of the initial SLE
manifestations. The SLE Disease Activity Index was variable (3/5 with high
activity). Time to nadir ranged from 6 to 72?h. All had severe impairment, with
motor deficit, sensory level and urinary retention. Magnetic resonance imaging
was abnormal in all cases, 3/5 presented a longitudinally extensive myelitis.
Serum analysis revealed positive antinuclear antibodies at a high titer in all
patients, 4/5 had low complement levels and 3/5 had anti-phospholipids positive.
The treatment (methylprednisolone and, in some cases, cyclophosphamide,
anticoagulation and/or plasmapheresis) produced partial improvement or no
benefits. One patient died due to sepsis. The others showed significant
disability at 6 months (European Database for Multiple Sclerosis grading
scale=6-8). In view of these results, myelitis associated with lupus shows
heterogeneity of the clinical, radiological and serological features. In our
experience, the cases were severe and with poor response to treatment. Further
studies are required to understand this disease and establish a more efficient
treatment.