Coexistence of systemic lupus erythematosus and multiple sclerosis. A case report and literature review

Sánchez, Elisa Carolina Jácome; Castillo, María Ariana García; González, Victor Paredes; López, Fernando Guillén; Correa-Díaz, Edgar Patricio

doi:10.1177/2055217318768330

Cited by 12 publications

(13 citation statements)

References 43 publications

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“…True co-existence of lupus and MS is uncommon ( 19 , 87 ), and there is no convincing evidence that lupus can cause an MS-like syndrome ( 87 ). In patients with both lupus and convincing clinical and paraclinical evidence of MS ( 88 ), a more plausible explanation is that, as is sometimes seen autoimmunity, the two diseases co-exist in a single individual ( 89 ). This presents a specific management challenge of identifying immunotherapies that might offer efficacy against both diseases.…”

Section: Clinical Approach In Neurolupusmentioning

confidence: 99%

Neurological Disease in Lupus: Toward a Personalized Medicine Approach

et al. 2018

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The brain and nervous system are important targets for immune-mediated damage in systemic lupus erythematosus (SLE), resulting in a complex spectrum of neurological syndromes. Defining nervous system disease in lupus poses significant challenges. Among the difficulties to be addressed are a diversity of clinical manifestations and a lack of understanding of their mechanistic basis. However, despite these challenges, progress has been made in the identification of pathways which contribute to neurological disease in SLE. Understanding the molecular pathogenesis of neurological disease in lupus will inform both classification and approaches to clinical trials.

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Section: Clinical Approach In Neurolupusmentioning

confidence: 99%

Neurological Disease in Lupus: Toward a Personalized Medicine Approach

et al. 2018

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“…Among them, multiple sclerosis and anti-aquaporin-4 antibody (AQP4) mediated neuromyelitis optica (NMO) may be difficult to distinguish clinically from SLE myelitis. 21,22 Differentiating between these three conditions is important because they require different treatment approaches. 23, 24, 25 Thus, we sought to compare the demographic, clinical, laboratory, and radiographic characteristics of these three conditions within an SLE registry from a large academic hospital in Boston, Massachusetts (MA).…”

Section: Introductionmentioning

confidence: 99%

Spinal cord syndromes in patients with systemic lupus erythematosus: differentiating lupus myelitis, neuromyelitis optica, and multiple sclerosis

Williams

Speyer

Kreps

et al. 2019

Lupus

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Objective Non-infectious myelitis in systemic lupus erythematosus (SLE) may be due to SLE myelitis, comorbid multiple sclerosis (MS), or neuromyelitis optica (NMO). We compared characteristics of these three conditions in SLE patients at a large academic institution. Methods We searched for neurologic diagnoses of SLE myelitis, NMO myelitis, and MS myelitis among 2297 patients with at least four 1997 American College of Rheumatology revised criteria for SLE between 2000 and 2015. Each subject was reviewed by a neurologist to confirm the underlying neurologic diagnosis. Demographic, clinical, laboratory, and radiographic data were extracted and compared using Fisher's exact test, analysis of variance, and Wilcoxon rank-sum test. Results Fifteen of the 2297 subjects with SLE (0.7%) met criteria for a spinal cord syndrome: seven had SLE myelitis, three had AQP4 seropositive NMO, and five had MS. The median SLE Disease Activity Index 2000 score at time of neurologic syndrome presentation was higher in SLE myelitis subjects (8, interquartile range (IQR) 7–16) compared with subjects with NMO (6, IQR 0–14) or MS (2, IQR 0–4), p = 0.02. Subjects with SLE myelitis were also more likely to have elevated anti-dsDNA antibodies at presentation (86%) compared with subjects with NMO (33%) or MS (0%), p = 0.03. Conclusion Myelitis occurs rarely among patients with SLE. Compared with subjects with SLE + NMO and subjects with SLE + MS, subjects with SLE myelitis had higher SLE disease activity at presentation.

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“…Disorders due to systemic autoantibodies, which include ANAs, ENAs, RFs, and ANCAs, affect multiple organs or systems. Several previous reports have found the idiopathic inflammatory demyelinating diseases have positive systemic autoantibodies and comorbidities with systemic autoimmune disorders (5,14). In our previous study, we found 25.8% NMOSD comorbidities with systemic or organspecific autoimmune disorders (6).…”

Section: Discussionmentioning

confidence: 49%

Serum Systemic Autoantibodies in Anti-N-Methyl-D-Aspartate Receptor Encephalitis

et al. 2020

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The aim of this retrospective study was to investigate the relationship between serum systemic autoantibodies and anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Methods: Thirty-nine patients with anti-NMDAR encephalitis were examined for serum systemic autoantibodies (antinuclear antibodies, extractable nuclear antigen autoantibodies, rheumatoid factors, and anti-neutrophil cytoplasmic antibodies), in comparison with 39 neuromyelitis optica spectrum disorder (NMOSD) and 78 healthy controls. Clinical features, cerebrospinal fluid characteristics, and outcomes were compared between the two subgroups of anti-NMDAR patients with positive and negative systemic autoantibodies, respectively. Results: Anti-NMDAR encephalitis patients had higher frequency of positive serum systemic autoantibodies than healthy controls (23.1 vs. 2.6%, p = 0.001) and lower frequency than NMOSD (23.1 vs. 48.7%, p = 0.018). No patients were diagnosed comorbidities with non-organ-specific autoimmune diseases. Consciousness disturbance was more frequent in autoantibodies positive group than in the negative group (88.9 vs. 40.0%, p = 0.02). Autoantibody positive group had a poorer outcome than autoantibody negative group (55.6 vs. 86.7%, p = 0.043). There was a negative correlation between serum autoantibodies and outcomes in anti-NMDAR encephalitis patients (r = −0.325, p = 0.044). Conclusion: Our data demonstrated serum systemic autoantibodies were more frequent in anti-NMDAR encephalitis patients than in healthy controls and less frequent than NMOSD, which were associated with higher severity of disease.

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Coexistence of systemic lupus erythematosus and multiple sclerosis. A case report and literature review

Cited by 12 publications

References 43 publications

Neurological Disease in Lupus: Toward a Personalized Medicine Approach

Neurological Disease in Lupus: Toward a Personalized Medicine Approach

Spinal cord syndromes in patients with systemic lupus erythematosus: differentiating lupus myelitis, neuromyelitis optica, and multiple sclerosis

Serum Systemic Autoantibodies in Anti-N-Methyl-D-Aspartate Receptor Encephalitis

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