Neuromyelitis optica (Devic’s syndrome) as first manifestation of                 systemic lupus erythematosus

Jacobi, Christian; Stingele, Karoline; Kretz, Rebekka; Hartmann, Martin; Storch-Hagenlocher, B.; Breitbart, A; Wildemann, Brigitte

doi:10.1191/0961203306lu2265cr

Cited by 50 publications

(31 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…LM is a characteristic finding in NMO/NMOSD and its presence may be used to differentiate from myelitis in classic MS, which rarely extends beyond a single vertebral segment (33). Longitudinal cord involvement has been reported in SLE and SS as well (7,8,14,17,22,23,30,34,35). These reports have identified a high prevalence of the NMO-IgG antibody and additional features consistent with concurrent NMO/NMOSD in these patients.…”

Section: Discussionmentioning

confidence: 80%

See 1 more Smart Citation

Neuromyelitis optica spectrum disorder in patients with connective tissue disease and myelitis

Kolfenbach

Horner

Ferucci

et al. 2011

Arthritis Care & Research

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 80%

“…Lumbar puncture (LP) may serve as an additional tool to help differentiate NMO from MS: 70% of cases of NMO are negative for oligoclonal bands (OCBs), in contrast to MS, where Ͼ95% are typically positive (17,36). In our cohort, 12 patients had LP data, 10 of which had testing for OCBs.…”

Section: Discussionmentioning

confidence: 99%

Neuromyelitis optica spectrum disorder in patients with connective tissue disease and myelitis

Kolfenbach

Horner

Ferucci

et al. 2011

Arthritis Care & Research

View full text Add to dashboard Cite

“…(2) Analysis of the CSF in these patients with normal spinal MRI, demonstrated the presence of OCB or elevated protein levels, but no vigorous inflammatory reaction, along with the lack of demyelination, suggest that parenchymatous neurons are the sites of the pathologic involvement, and are are analogous to the acute lesions of axonal polyneuropathy. Such cases could be variants of DEM although similar cases were described in patient with SLE and was regarded as part of NMO spectrum (45). It was found that about 40% of acute transverse myelopathies cannot be documented by MRI (17)…”

Section: Inflammatory Myelopathiesmentioning

confidence: 98%

Current concepts in the diagnosis of transverse myelopathies

Brinar

Habek

Zadro

et al. 2008

Clinical Neurology and Neurosurgery

View full text Add to dashboard Cite

“…For example, Provenzale et al reported eight episodes of transverse myelitis in four patients and consistently observed prolonged signals on T1-or T2-weighted MRIs as well as cord enlargement in 75% of the episodes [36]. Moreover, Deodhar et al reported the first case of SLE with longitudinal myelitis in 1999 [37] and other groups have reported MRI findings of NPSLE with longitudinal spinal involvement [38,39] (Figure 1C), many of which showed T2-hyperintense lesions in central regions of the spinal cord and cord swelling, which are the typical MRI findings in NMO ( Figure 1D …”

Section: Mris Of Npsle With Optic Neuritis or Myelitismentioning

confidence: 99%

Systemic Lupus Erythematosus with Neuromyelitis Optica

Takahashi¹

2014

J Clin Cell Immunol

View full text Add to dashboard Cite

Systemic lupus erythematosus (SLE) is an autoimmune disease that can have detrimental effects on many different systems in the body, including the central nervous system. Neuropsychiatric SLE (NPSLE) refers to several different neurological and/or behavioral clinical syndromes, and has been reported as having a prevalence rate of approximately 30−40%, while manifestation of myelitis or optic neuritis of NPSLE is rare (~1%). Myelitis and optic neuritis are easily identifiable since myelitis is frequently transverse, and manifests as severe disturbances in both motor and sensory pathways, while optic neuritis is often both bilateral and severe. At least 85% of patients experience relapses in the form of optic neuritis, transverse myelitis, or both. Furthermore, some cases of NPSLE with optic neuritis are often complicated by myelitis. Interestingly, the characteristics of myelitis or optic neuritis in NPSLE are quite similar to neuromyelitis optica (NMO), a disease characterized by bilateral optic neuropathy and transverse myelopathy. In fact, magnetic resonance imaging (MRI) of patients with NPSLE has demonstrated longitudinal spinal involvement showing cord swelling and hyperintense lesions in central regions. These findings are also typically observed in MRIs of patients with NMO. Additionally, anti-aquaporin 4 (AQP4) antibodies have been discovered in patients with NMO and with NPSLE with myelitis and/or optic neuritis. Therefore, complications that are often encountered with NMO should be considered when treating cases of NPSLE with myelitis and/or optic neuritis. Moreover, since the treatment of NMO closely resembles the therapeutic approaches taken for NPSLE, corticosteroids alone or in combination with immunosuppressants could prove effective in reducing incidents of relapse. Some patients, however, may be refractory to steroid therapy; in such cases, plasma exchange may have priority over other second-line therapeutic strategies, such as intravenous immunoglobulin and rituximab, because of treatment approaches typically employed in NMO. In this review, I will discuss pathological similarities between NPSLE with myelitis and/or optic neuritis and NMO with the aim of demonstrating that our knowledge of NMO should be considered when treating NPSLE with myelitis and/or optic neuritis.

show abstract

Neuromyelitis optica (Devic’s syndrome) as first manifestation of systemic lupus erythematosus

Cited by 50 publications

References 14 publications

Neuromyelitis optica spectrum disorder in patients with connective tissue disease and myelitis

Neuromyelitis optica spectrum disorder in patients with connective tissue disease and myelitis

Current concepts in the diagnosis of transverse myelopathies

Systemic Lupus Erythematosus with Neuromyelitis Optica

Contact Info

Product

Resources

About