Atormac
Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 2930  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 Search
 
  
 Resource Links
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (421 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this Article
   References
   Article Figures

 Article Access Statistics
    Viewed902    
    Printed29    
    Emailed0    
    PDF Downloaded52    
    Comments [Add]    
    Cited by others 1    

Recommend this journal

 


 
Table of Contents    
LETTER TO EDITOR
Year : 2014  |  Volume : 62  |  Issue : 6  |  Page : 712-713

Acute transverse myelitis as the first clinical manifestation of systemic lupus erythematosus


1 Department of Neurology, Medical University, Wroclaw, Poland
2 Department of Neuroradiology, Medical University, Wroclaw, Poland
3 Department of Rheumatology, Medical University, Wroclaw, Poland

Date of Submission30-Nov-2014
Date of Decision05-Dec-2014
Date of Acceptance05-Dec-2014
Date of Web Publication16-Jan-2015

Correspondence Address:
Justyna Chojdak-Lukasiewicz
Department of Neurology, Medical University, Wroclaw
Poland
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.149462

Rights and Permissions



How to cite this article:
Loster-Niewinska A, Chojdak-Lukasiewicz J, Sasiadek M, Szmyrka-Kaczmarek M, Paradowski B. Acute transverse myelitis as the first clinical manifestation of systemic lupus erythematosus. Neurol India 2014;62:712-3

How to cite this URL:
Loster-Niewinska A, Chojdak-Lukasiewicz J, Sasiadek M, Szmyrka-Kaczmarek M, Paradowski B. Acute transverse myelitis as the first clinical manifestation of systemic lupus erythematosus. Neurol India [serial online] 2014 [cited 2019 Sep 22];62:712-3. Available from: http://www.neurologyindia.com/text.asp?2014/62/6/712/149462


Sir,

A 24-year-old man was admitted due to sudden onset of lower limbs paralysis accompanied by sensory deficit below the T10 level and double sphincters dysfunction. Above symptoms were preceded by fever and low back pain. There were signs of kidney involvement in the urinalysis. Serological examination showed positive antinuclear antibodies, anti-double stranded deoxyribonucleic acid (dsDNA) antibodies, anti-Rib-P antibodies, and anti-pregnenolone-16a-carbonitrile (PCN) antibodies. Cerebrospinal fluid analysis showed a white cell count of 194/ul with elevated proteins (280 mg/dl). Magnetic resonance imaging (MRI) revealed large area of thickening and edema of the spinal cord from the level of T7 vertebra to the conus medullaris. In the periphery, there were hyperintense foci in T1-weighted images, compatible with the previous bleeding (methemoglobin phase) [Figure 1]. The patient was treated with plasmapheresis, intravenous human immunoglobulin (0,4 g/kg daily for 3 days), intravenous methyloprednisolone (1 g daily for 3 days), and cyclophosphamide (800 mg daily) pulse therapy, with no clinical improvement.
Figure 1: Magnetic resonance imaging (MRI) of the thoracic spine: T2-weighted (a) and T1-weighted fat saturation (b) sagittal images. The spinal cord is thickened from T7 to L1 level, with hyperintensity on T2-weighted image compatible with edema and inflammation) and hyperintense foci on T1-weighted image (compatible with previous bleeding)

Click here to view


Systemic lupus erythematosus (SLE) is a rare cause of transverse myelitis (1-2%) of uncertain pathomechanism, although vasculitis and arterial thrombosis have been suggested. [1],[2]

 
  References Top

1.
Theodoridou A, Settas L. Demyelination in rheumatic diseases. J Neurol Neurosurg Psychiatry 2006;77:290-5.  Back to cited text no. 1
    
2.
Birnbaum J, Petri M, Thompson R, Izbudak I, Kerr D. Distinct subtypes of myelitisin systemic lupus erythematosus. Arthritis Rheum 2009;60:3378-87.  Back to cited text no. 2
    


    Figures

  [Figure 1]

This article has been cited by
1 Clinical value of autoantibodies for lupus myelitis and its subtypes: A systematic review
Hiroshi Oiwa,Akira Kuriyama,Tomoyasu Matsubara,Eiji Sugiyama
Seminars in Arthritis and Rheumatism. 2018;
[Pubmed] | [DOI]



 

Top
Print this article  Email this article
   
Online since 20th March '04
Published by Wolters Kluwer - Medknow