دورية أكاديمية

Natural history of longitudinally extensive transverse myelitis in 35 Hispanic patients with systemic lupus erythematosus: good short-term functional outcome and paradoxical increase in long-term mortality

التفاصيل البيبلوغرافية
العنوان: Natural history of longitudinally extensive transverse myelitis in 35 Hispanic patients with systemic lupus erythematosus: good short-term functional outcome and paradoxical increase in long-term mortality
المؤلفون: Flores-Silva, F D, Longoria-Lozano, O, Aguirre-Villarreal, D, Sentíes-Madrid, H, Vega-Boada, F, Díaz de León-Sánchez, E, Murra-Antón, S, Morales-Moreno, S, Quintanilla-González, L, Fragoso-Loyo, H, Guraieb-Chaín, P, Higuera-Calleja, J, Ceballos-Ceballos, J, Treviño-Frenk, I, González-Duarte, A, Dávila-Maldonado, L, Cantú-Brito, C, Valdés-Ferrer, S I
المصدر: Lupus ; volume 27, issue 8, page 1279-1286 ; ISSN 0961-2033 1477-0962
بيانات النشر: SAGE Publications
سنة النشر: 2018
مصطلحات موضوعية: Rheumatology
الوصف: Background and objective Acute transverse myelitis (TM) is an infrequent neurological complication of systemic lupus erythematosus (SLE). Short-term outcome varies widely between cohorts. Little is known about the epidemiology and long-term functional outcome of TM associated to SLE. Methods Patients with SLE and acute TM were identified during hospital admission, visits to the Emergency Room or the Neurology Outpatient Clinic. We evaluated ambispectively those patients with SLE presenting with clinical myelopathy and corroborated with spinal MRI. Cases were divided as partial (non-paralyzing) or complete (paralyzing). We determined long-term functional outcome as well as mortality in those patients with follow-up periods of at least five years. Results We identified 35 patients (partial, n = 15; complete, n = 20) in which complete clinical and imaging data were available (26 with follow-up ≥ 5 years). Patients with complete TM were significantly older than those with partial forms. Positive antiphospholipid antibodies were observed in 80% of patients, suggesting a possible mechanistical role. Surprisingly, functional recovery at one year was in general good; however, we observed a five-year mortality of 31% because of sepsis (in 10 cases) or pulmonary embolism (in one case). Conclusions Short-term outcome of SLE-related TM is generally good, and recurrence rate is low. However, we observed a long-term fatality rate of 31% for reasons unrelated to TM, suggesting that TM is a manifestation of severe immune dysregulation and a predictor of severity and mortality in patients with SLE.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1177/0961203318770015
الإتاحة: https://doi.org/10.1177/0961203318770015Test
حقوق: http://journals.sagepub.com/page/policies/text-and-data-mining-licenseTest
رقم الانضمام: edsbas.98267BC8
قاعدة البيانات: BASE