Myelopathy in systemic lupus erythematosus: clinical, laboratory, radiological and progression findings in a cohort of 1,193 patients

Costallat, Beatriz Lavras; Ferreira, Daniel Miranda; Costallat, Lílian Tereza Lavras; Appenzeller, Simone

doi:10.1016/j.rbre.2016.03.006

Cited by 16 publications

(17 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We found that the majority of patients developed TM after the diagnosis of SLE, a nding which is consistent with those of previous studies [4,[15][16][17][18]. Of note, the diagnosis of SLE-associated TM is usually simple when the TM occurs in the background of SLE, while the development of TM as the rst manifestation of SLE may pose a challenge to SLE diagnosis due to the heterogeneity of presenting clinical characteristics.…”

Section: Discussionsupporting

confidence: 90%

Identification of Risk and Prognostic Factors for Transverse Myelitis in Systemic Lupus Erythematosus

Wang

Zhang

et al. 2021

Preprint

View full text Add to dashboard Cite

Purpose: Our aim in this study was to describe the clinical characteristics and outcomes of patients with transverse myelitis (TM) as a rare phenotype of systemic lupus erythematosus (SLE) and to identify the risk and prognostic factors for SLE-related TM.Methods: The analysis was based on 58 patients with SLE-related TM admitted to Peking Union Medical College Hospital between January 1993 and May 2021.The control group included 101 patients, randomly selected from our SLE patient group, without TM, using propensity score matching for age at SLE diagnosis, sex, and SLE disease course. Conditional logistic regression and Cox proportional hazard regression were used to identify risk and prognostic factors for SLE-related TM. Results: Multivariate analysis revealed that anti-SSA(p<0.001) and anti-RNP positivity (p=0.005) were independent risk factors for SLE-related TM. With regard to prognosis, an American Spinal Injury Association Impairment Scale (AIS) grade of A or B at the early stage of TM (p<0.001) and hypoglycorrhachia (p=0.016) were independent risk factors for unfavourable neurological outcomes. In regard to neurological recovery at 3 months, an American Spinal Injury Association Impairment Scale (AIS) grade of A, B, or C at the early stage of TM was the only prognostic factor for SLE-related TM (hazard ratio, 0.26; 95% confidence interval, 0.08-0.91; p=0.035). Conclusions: Anti-SSA and anti-RNP positivity were independent risk factors for TM in patients with SLE. Initial severe myelitis and hypolycorrhachia are predictive of a poor prognosis. Glucocorticoid pulse therapy provided within 2 weeks of TM onset may improve TM prognosis. Understanding the risk and prognostic factors of TM is important as permanent neurological disability persists in a significant proportion of patients with SLE-related TM.

show abstract

Section: Discussionsupporting

confidence: 90%

Identification of Risk and Prognostic Factors for Transverse Myelitis in Systemic Lupus Erythematosus

Wang

Zhang

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Transverse myelitis in association with APS is rare, with an estimated prevalence of approximately 1% [ 12 , 19 ] presenting with symmetrical paraparesis, sensory loss and sphincter dysfunction. As with many of the neurological manifestations associated with APS, transverse myelitis is also seen in patients with SLE and that is where most of the literature is focused [ 120 , 121 ].…”

Section: Manifestations Other Than Cerebrovascular Diseasementioning

confidence: 99%

Neuropsychiatric Manifestations of Antiphospholipid Syndrome—A Narrative Review

Man

Sanna

2022

Brain Sciences

View full text Add to dashboard Cite

Antiphospholipid syndrome (APS) is a common autoimmune pro-thrombotic condition characterised by thrombosis and pregnancy morbidity. There are a broad range of neuropsychiatric manifestations associated with APS, from focal symptoms to more global dysfunction. Patients commonly present with transient ischaemic attacks and ischaemic strokes, with identifiable lesions on brain imaging. However, the underlying pathogenesis remains uncertain in other manifestations, such as cognitive dysfunction, seizures, headache and chorea. The aim is to provide a comprehensive review of the various neuropsychiatric manifestations associated with APS. A detailed literature search was applied to PubMed, including citations from 1983 to December 2021.

show abstract

“…When considering inflammatory or infections etiologies of myelopathy, visualization of the osseous spinal column as well as the spinal cord is useful and best accomplished noninvasively by MRI [4,7,45,[52][53][54][55][56][57][58][59][60].…”

Section: Discussion Of Procedures By Variant Variant 1: Acute Onset Myelopathy Initial Imagingmentioning

confidence: 99%

ACR Appropriateness Criteria® Myelopathy: 2021 Update

Imaging¹,

Agarwal

Shah

et al. 2021

Journal of the American College of Radiology

View full text Add to dashboard Cite

Myelopathy is a clinical diagnosis with localization of the neurological findings to the spinal cord, rather than the brain or the peripheral nervous system, and then to a particular segment of the spinal cord. Myelopathy can be the result of primary intrinsic disorders of the spinal cord or from secondary conditions, which result in extrinsic compression of the spinal cord. While the causes of myelopathy may be multiple, the acuity of presentation and symptom onset frame a practical approach to the differential diagnosis. Imaging plays a crucial role in the evaluation of myelopathy with MRI the preferred modality.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

show abstract

Myelopathy in systemic lupus erythematosus: clinical, laboratory, radiological and progression findings in a cohort of 1,193 patients

Abstract: Myelopathy occurred in 14 (1.2%) of the patients in our cohort and this may be the first manifestation of the disease occurring independently of systemic disease activity. Although rare, myelopathy shows great morbidity and mortality, can be recurrent and MRI is critical for diagnosis.

Cited by 16 publications

References 21 publications

Identification of Risk and Prognostic Factors for Transverse Myelitis in Systemic Lupus Erythematosus

Identification of Risk and Prognostic Factors for Transverse Myelitis in Systemic Lupus Erythematosus

Neuropsychiatric Manifestations of Antiphospholipid Syndrome—A Narrative Review

ACR Appropriateness Criteria® Myelopathy: 2021 Update

Contact Info

Product

Resources

About