Myelitis in systemic lupus erythematosus: clinical features, immunological profile and magnetic resonance imaging of five cases

Hryb, Javier; Chiganer, Edson; Contentti, Edgar Carnero; Pace, José Luis Di; Lessa, Carmen; Perassolo, Mónica

doi:10.1038/scsandc.2016.5

Cited by 24 publications

(44 citation statements)

References 25 publications

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“…Data on myelitis in the setting of other rheumatic disorders has been detailed in Supplementary Table 3 . 13 , 18 , 19 The other series shows female preponderance, although patients were younger in our series. LM was seen in most cases, but ON was higher in the case series from Tianjin.…”

Section: Discussioncontrasting

confidence: 45%

Spectrum of Myelitis in Systemic Lupus Erythematosus: Experience from a Single Tertiary Care Centre over 25 Years

Mehta

Gupta

Muhammed

et al. 2021

MJR

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Background: Inflammatory myelitis rarely occurs in Systemic Lupus Erythematosus (SLE). Methods: Medical records from a tertiary care centre in India (1989–2018) were reviewed to identify patients with myelitis in SLE and their clinical characteristics and outcomes were compared with two matching comparators drawn from adjacent hospital registration numbers in the SLE database. Results: Ten patients had myelitis from a cohort of 1768 patients with SLE. Myelitis was the first manifestation of lupus in 7 (70%). Cervicothoracic cord was most frequent site of involvement. ANA was negative at onset in 2 cases. One of 4 was positive for Anti-Aquaporin 4 antibody. Four had relapsing disease (16 events) with a median time to relapse of 0.65 years (0.3– 7 years). All cases received steroid sparing agents over the follow-up duration (78.5 patient years). Lupus nephritis (20% vs. 75%, p=0.004) and haematologic manifestations (0 vs. 25%, p=0.02) were less common. Higher frequency of anti-Ro antibodies was noted in the group with myelitis (p=0.05). Conclusion: Myelitis can be a presenting feature of SLE with lupus nephritis and hematologic involvement being rare. Relapses are common that mandate long-term immunosuppression.

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Section: Discussioncontrasting

confidence: 45%

Spectrum of Myelitis in Systemic Lupus Erythematosus: Experience from a Single Tertiary Care Centre over 25 Years

Mehta

Gupta

Muhammed

et al. 2021

MJR

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“…The functional deficits associated with these three conditions are particularly concerning given that they tend to affect young and middle-aged adults, with a mean age at onset in the 5 th decade of life in our study. Other studies have similarly reported a mean age at SLE myelitis onset of 25–42 years 10, 13–14 , NMO median age at onset in the late 4 th decade, 31 and MS mean age at onset of 28–31 years. 32 Interestingly, our small study population was more likely to be white (93%) than the general SLE population of the hospital which participated in the study (66% white).…”

Section: Discussionmentioning

confidence: 68%

“…This pattern may also occur in SLE myelitis as noted in several studies. 7,8,11,14 In addition, we found that radiographic improvement may temporally lag clinical improvement, as all subjects with follow-up imaging had persistent radiographic lesions at 6 months or later. Thus, it appears that following a patient's examination and symptoms may be more likely to assist with prognostication than subsequent imaging.…”

Section: Discussionmentioning

confidence: 70%

“…The majority of our SLE myelitis group had antiphospholipid antibodies (71%), which has been noted in other studies. 9,13,14,20 This is in contrast to the general SLE population in which 30–40% have antiphospholipid antibodies. 36 The majority of subjects in the NMO and MS groups did not have antiphospholipid antibodies, but these differences did not reach statistical significance.…”

Section: Discussionmentioning

confidence: 97%

“…4 Several case series and small case-control studies have examined patients with SLE myelitis and have found that the clinical presentation, laboratory evaluation, and radiographic features of this disease are often heterogeneous. 5–20 In addition, several other autoimmune conditions may affect the spinal cord. Among them, multiple sclerosis (MS) and anti-aquaporin-4 antibody (AQP4)-mediated neuromyelitis optica (NMO) may be difficult to distinguish clinically from SLE myelitis.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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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Acute transverse myelitis revealing ankylosing spondylitis: A case report and literature review

Boussaid

Rahmouni

Rekik

et al. 2021

Clinical Case Reports

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Myelitis in systemic lupus erythematosus: clinical features, immunological profile and magnetic resonance imaging of five cases

Cited by 24 publications

References 25 publications

Spectrum of Myelitis in Systemic Lupus Erythematosus: Experience from a Single Tertiary Care Centre over 25 Years

Spectrum of Myelitis in Systemic Lupus Erythematosus: Experience from a Single Tertiary Care Centre over 25 Years

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

Acute transverse myelitis revealing ankylosing spondylitis: A case report and literature review

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