Transverse Myelitis in Systemic Lupus Erythematosus
| العنوان: | Transverse Myelitis in Systemic Lupus Erythematosus |
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| المؤلفون: | Erick Adrian Zamora Tehozol, María Belén Nacimiento Cantero, Pedro Delgadillo, María Fernanda Farfan, Edgar Carnero Contentti, Lucas Alessandro, Edgar Patricio Correa Díaz, Jorge Correale, Javier Pablo Hryb, Edson Chiganer, Analía Cardozo, Hilda Esther Fragoso-Loyo, Isabel Acosta Colman, Mauro Stagno, Magaly Alva Linares, Marvin Sánchez Benavides, María Angela Carreño Nigro, Franco Pacello, José Luis Di Pace, Lauro Quintanilla-González, Emilia Inoue Sato, Patricia Melgarejo, Elisa Carolina Jácome Sánchez, Edgard Torres do Reis-Neto, Marcos Aurelio Vazquez Baez, Carmen Lessa, Mónica Perassolo, Graciana Lourdes Galiana, Juan Gabriel Elizaur López, José Antonio de Jesús Batún-Garrido |
| المصدر: | JCR: Journal of Clinical Rheumatology. 27:S204-S211 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Adult, medicine.medical_specialty, Myelitis, Myelitis, Transverse, Transverse myelitis, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Internal medicine, medicine, Humans, Lupus Erythematosus, Systemic, 030212 general & internal medicine, 030203 arthritis & rheumatology, Lupus erythematosus, business.industry, Multiple sclerosis, Hypoesthesia, Prognosis, medicine.disease, Latin America, Acute Transverse Myelitis, Hypoglycorrhachia, Female, Neoplasm Recurrence, Local, medicine.symptom, business |
| الوصف: | BACKGROUND Acute transverse myelitis (ATM) is an infrequent but severe complication of systemic lupus erythematosus (SLE). The purpose of study was to describe clinical features and prognostic factors of patients with SLE-related ATM. METHODS In this medical records review study, data were collected from 60 patients from 16 centers seen between 1996 and 2017 who met diagnostic criteria for SLE and myelitis as defined by the American College of Rheumatology/Systemic International Collaborating Clinics and the Working Group of the Transverse Myelitis Consortium, respectively. Objective neurological impairment was measured with American Spinal Injury Association Impairment Scale (AIS) and European Database for Multiple Sclerosis Grade Scale (EGS). RESULTS Among patients included, 95% (n = 57) were female, and the average age was 31.6 ± 9.6 years. Myelitis developed after diagnosis of SLE in 60% (n = 36). Symmetrical paraparesis with hypoesthesia, flaccidity, sphincter dysfunction, AIS = A/B, and EGS ≥ 8 was the most common presentation. Intravenous methylprednisolone was used in 95% (n = 57), and 78.3% (n = 47) received intravenous cyclophosphamide. Sensory/motor recovery at 6 months was observed in 75% (42 of 56), but only in 16.1% (9 of 56) was complete. Hypoglycorrhachia and EGS ≥ 7 in the nadir were associated with an unfavorable neurological outcome at 6 months (p < 0.05). A relapse rate during follow-up was observed in 30.4% (17 of 56). Hypoglycorrhachia and hypocomplementemia seem to be protective factors for relapse. Intravenous cyclophosphamide was associated with time delay to relapse. CONCLUSIONS Systemic lupus erythematosus-related ATM may occur at any time of SLE course, leading to significant disability despite treatment. Relapses are infrequent and intravenous cyclophosphamide seems to delay it. Hypoglycorrhachia, hypocomplementemia, and EGS at nadir are the most important prognostic factors. |
| تدمد: | 1536-7355 1076-1608 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::747c293eb2d9979947e3bf0fa318262bTest https://doi.org/10.1097/rhu.0000000000001322Test |
| رقم الانضمام: | edsair.doi.dedup.....747c293eb2d9979947e3bf0fa318262b |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15367355 10761608 |
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