Transverse myelitis in mixed connective tissue disease

Pedersen, Claus Hougaard; Bonen, H.; Boesen, Finn

doi:10.1007/bf02201041

Cited by 24 publications

(8 citation statements)

References 6 publications

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“…[368][369][370] Psoriatic arthritis 371 Mixed connective tissue disease Female preponderance; predilection for the thoracic cord. [372][373][374][375][376][377] Systemic sclerosis Rare and typically compressive in etiology. Progressive myelopathy, subacute TM, and NMO-IgG positive LETM have been reported.…”

Section: Disordermentioning

confidence: 99%

Transverse Myelitis

et al. 2013

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Transverse myelitis (TM) includes a pathobiologically heterogeneous syndrome characterized by acute or subacute spinal cord dysfunction resulting in paresis, a sensory level, and autonomic (bladder, bowel, and sexual) impairment below the level of the lesion. Etiologies for TM can be broadly classified as parainfectious, paraneoplastic, drug/toxin-induced, systemic autoimmune disorders, and acquired demyelinating diseases. We discuss the clinical evaluation, workup, and acute and long-term management of patients with TM. Additionally, we briefly discuss various disease entities that may cause TM and their salient distinguishing features, as well as disorders that may mimic TM.

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Section: Disordermentioning

confidence: 99%

Transverse Myelitis

et al. 2013

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“…Firstly, there are striking similarities between NMO and a variant of MOG-induced experimental allergic encephalomyelitis (EAE) in Brown Norway rats which develop a marked antibody response associated with pronounced demyelination mainly affecting the optic nerves and the spinal cord 93 . Secondly, NMO patients have a number of circulating autoantibodies and many of them have autoimmune co-morbidities such as Sjögren syndrome, systemic lupus erythematosus and mixed connective tissue disease [94][95][96][97][98][99][100][101][102][103] . Finally, some treatment peculiarities such as improvement of corticosteroid-refractory acute attacks following plasma exchange 104,105 and a better response with general immunossupression than with standard MS immunomodulatory drugs 106,107 strongly support the role of autoantibodies in the disease process.…”

Section: Pathology and Immunopathogenesismentioning

confidence: 99%

Devic’s neuromyelitis optica: a critical review

Lana-Peixoto

2008

Arq. Neuro-Psiquiatr.

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-Devic's neuromyelitis optica (NMO) is an idiopathic inflammatory demyelinating and necrotizing disease characterized by predominant involvement of the optic nerves and spinal cord. In Asian countries relapsing NMO has been known as opticospinal multiple sclerosis. It has long been debated if NMO is a variant of multiple sclerosis (MS) or a distinct disease. Recent studies have shown that NMO has more frequently a relapsing course, and results from attack to aquaporin-4 which is the dominant water channel in the central nervous system, located in foot processes of the astrocytes. Distinctive pathological features of NMO include perivascular deposition of IgG and complement in the perivascular space, granulocyte and eosinophil infiltrates and hyalinization of the vascular walls. These features distinguish NMO from other demyelinating diseases such as MS and acute demyelinating encephalomyelopathy. An IgG-antibody that binds to aquaporin-4, named NMO-IgG has high sensitivity and specificity. Magnetic resonance imaging (MRI) studies have revealed that more frequently there is a long spinal cord lesion that extends through three or more vertebral segments in length. Brain MRI lesions atypical for MS are found in the majority of cases. Treatment in the acute phase includes intravenous steroids and plasma exchange therapy. Immunosupressive agents are recommended for prophylaxis of relapses.KEY WORS: Devic's neuromyelitis optica, opticospinal multiple sclerosis, recurring optic neuritis, transverse myelitis, aquaporin-4, NMO-IgG antibody. Neuromielite óptica de Devic: revisão críticaResumo -Neuromielite óptica ou doença de Devic (NMO) é uma doença inflamatória com desmielinização e necrose envolvendo preferencialmente os nervos ópticos e a medula espinal. Desde sua descrição inicial tem havido controvérsia se a NMO é uma variante da esclerose múltipla (EM) ou se é uma entidade independente. Na Ásia a doença é conhecida como esclerose múltipla óptico-espinal. Recentes avanços tem demonstrado que na maioria dos casos a NMO é recorrente e resulta de alterações inflamatórias por ataque à aquaporina-4, uma proteína localizada nos pés dos astrócitos na barreira hemato-encefálica. Patologicamente a NMO difere da EM pela presença de necrose e cavitação no centro da medula, deposição perivascular de IgG e complemento, infiltração de neutrófilos e eosinófilos, assim como por hiperplasia e hialinização dos vasos. O anticorpo contra a aquaporina-4 (IgG-NMO), detectado no soro dos pacientes, tem alta sensibilidade e especificidade. Imagem por ressonância magnética demonstra lesão medular que se estende três ou mais segmentos vertebrais. Na maioria dos casos há lesões cerebrais atípicas para EM. Corticosteróide venoso em altas doses e plasmaférese são usados no tratamento das fases agudas, enquanto os imunossupressores devem ser usados na profilaxia das recorrências. PALAVRAS-CHAVE: neuromielite óptica, doença de Devic, esclerose múltipla óptico-espinal, neurite óptica recorrente, mielite transversa, aquaporina-4, IgG-NMO.

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“…Neurological manifestations of mixed connective tissue disease (MCTD) are rare, although several case reports associate transverse myelitis with MCTD. [103][104][105] One report described a 19-year-old woman with MCTD who experienced recurrent bouts of either unilateral optic neuropathy or transverse myelopathy over several years. 106 The patient was treated successfully with plasmapheresis and immunosuppressive medications.…”

Section: Mixed Connective Tissue Diseasementioning

confidence: 99%

Neuromyelitis Optica

Cree¹,

Goodin²,

Hauser³

2002

Semin Neurol

123

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Whether neuromyelitis optica (NMO), the co-occurrence of myelitis and optic neuritis, is a variant of multiple sclerosis (MS) or a unique disease is controversial. Distinct neuropathological features and a fulminant clinical course argue in favor of NMO as a distinct disease. However, the combination of neurological impairments of myelitis and optic neuritis occurs in patients with several inflammatory disorders, including multiple sclerosis and collagen vascular diseases. NMO is also associated with certain infectious diseases. The fact that the NMO phenotype occurs in a variety of disease states suggests that NMO does not represent a specific clinical entity. To better understand NMO and its associations with recognized diseases, a systematic review of the literature using MEDLINE was conducted. The history of NMO, its nosology, associations with other diseases, and current concepts of its pathogenesis and treatment is reviewed in this article.

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Transverse myelitis in mixed connective tissue disease

Abstract: A case of transverse myelitis in a 16-year-old woman with mixed connective tissue disease is described. After treatment with azathioprine and prednisolone complete recovery was obtained.

Cited by 24 publications

References 6 publications

Transverse Myelitis

Transverse Myelitis

Devic’s neuromyelitis optica: a critical review

Neuromyelitis Optica

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