Transverse myelitis in systemic lupus erythematosus: A case report and systematic literature review |
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| Affiliation: | 1. Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, PR China;2. Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, PR China.;1. ARUP Laboratories, Salt Lake City, UT, United States of America;2. Department of Pathology, University of Utah, Salt Lake City, UT, United States of America;3. Department of Internal Medicine, Division of Rheumatology, University of Utah, Salt Lake City, UT, United States of America;1. Clinica Medica, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, via Tronto 10/A, 60126 Torrette di Ancona, Italy;2. Postgraduate School of Allergy and Clinical Immunology, Università Politecnica delle Marche, via Tronto 10/A, 60126 Ancona, Italy;3. Institute of Clinical Physiology, National Research Council of Italy (IFC-CNR), Via G. Moruzzi 1, 56124 Pisa, Italy;4. PostGraduate School of Internal Medicine, Università Politecnica delle Marche, via Tronto 10/A, 60126 Ancona, Italy;5. Scuola di Medicina e Chirurgia, Alma Mater Studiorum, Università degli Studi di Bologna, 40126 Bologna, Italy;6. Division of Haematology, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy;7. School and Operative Unit of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy;1. Division of Clinical Immunology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy;2. Immunology Reserach Core Facility, Gemelli Science and Technology Park - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, Italy;3. Università Cattolica del Sacro Cuore, Rome, Italy;4. Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy;1. Department of Internal Medicine - Multi-Organic Diseases, Local Referral Center for Rare Auto-immune Diseases, Montpellier University Hospital, Montpellier, France;2. Department of nephrology, Université de Montpellier, CHU de Montpellier, Montpellier, France.;3. Department of Epidemiology and Biostatistics, Montpellier University Hospital, Montpellier, France;4. Department of Rheumatology, Montpellier University Hospital, University of Montpellier, PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR, 9214 Montpellier, France;5. Department of Neurology, University Hospital of Montpellier, Montpellier, France;6. Internal Medicine Department, Nîmes University Hospital, Montpellier University, Nîmes, France;7. Institute of Regenerative Medicine and Biotherapy, Institut national de la santé et de la recherche médicale U1183, Montpellier, France |
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| Abstract: | ObjectiveAcute transverse myelitis (TM) is a rare complication secondary to systemic lupus erythematosus (SLE) that can cause patients' extensive and severe neuropsychiatric disorders. Due to the rarity of the onset of acute TM, there is still no standard treatment protocol. This study was to summarize the clinical features of SLE-TM through a case report and systematic review.MethodsWe report a case of acute TM with the initial symptoms of headache and fever on admission to hospital, with lesions in medulla oblongata, cervical medulla, and thoracic medulla. Furthermore, all cases of SLE combined with acute TM from January 1975 to February 2022 were concluded and reviewed to compare the disease's current treatment strategies and prognosis.ResultsPatients with SLE-TM are mainly female (97.65%), with an average age of 36.89, a TM incidence of 24.51% and a longitudinal myelitis (LM) incidence of 67.76%. In addition, 68.63% of patients present an increased albumin, and only 16.50% of patients could recover. 32.35% of patients showed positive anti-cardiolipin antibody. Moreover, the patients who could recover are generally younger than those in the improved and paraparesis groups. After classifying the statistical results twice according to magnetic resonance imaging results and prognosis respectively, the erythrocyte sedimentation rate (ESR) in LM group was significantly higher than that in the other two groups. The positive rate of anti-DNA and anti-cardiolipin antibody (ANCL) in TM group was significantly higher than that of the other groups. According to the prognostic grouping, ESR in the recovery group was significantly higher than those in the other two groups. The positive ANCL in the poor prognosis group was slightly higher than that in the other two groups.ConclusionWe offer a novel insight for this rare disease and hope to bring some inspiration the basic research for SLE-TM. |
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