Concomitant Occurrence of Cervical Myelopathy, Cerebral Infarction, and Peripheral Neuropathy in Systemic Lupus Erythematosus: A Case Report

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disease characterized by multiorgan involvement with diverse clinical presentations. Central nervous system involvement in neuropsychiatric syndromes of SLE (NPSLE), such as cerebrovascular disease and myelopathy, is a major cause of morbidity and mortality in SLE patients. The concomitant occurrence of myelopathy, cerebrovascular disease, and peripheral neuropathy in a patient with SLE has not yet been reported. We report on a 41-year-old woman with SLE who showed motor and sensory impairment with urinary retention and was diagnosed with cervical myelopathy and acute cerebral infarction by spine and brain magnetic resonance imaging and peripheral neuropathy by electrodiagnostic examination. Even though pathogenesis of NPSLE is not well elucidated, we assume that increased antibodies of anti-double stranded DNA (anti-dsDNA), presence of lupus anticoagulant and hypertension are risk factors that have caused neuropsychiatric lupus in this patient.

Is It Lupus? Is It Neuromyelitis Optica Spectrum Disorder (NMOSD)?—Why Not Both?

“…Regarding the formerly mentioned myelopathy as a possible manifestation of SLE, older reports have discussed several cases in which SLE patients suffered from myelopathy, even with extensive longitudinal myelitis over four or more spinal segments in some cases, which could also have indicated the presence of NMOSD. Unfortunately, AQP4 antibodies had not been tested or taken in consideration [9,[11][12][13][14].…”