Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024141 (systemic lupus erythematosus)
 44,322 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Antiphospholipid antibodies have been reported to occur in ischemic stroke patients, but there have been no previous reports linking these antibodies to spinal cord infarction. A case of spinal cord infarction associated with primary antiphospholipid syndrome in a 6-year-old boy is reported. Magnetic resonance imaging clearly demonstrated marked swelling of the thoracolumbar spinal cord with gadolinium-diethylenetriamine pentaacetic acid enhancement at an acute stage, followed later by cord atrophy. Serological study disclosed positive lupus anticoagulant and immunoglobulin G anticardiolipin antibody. It is suggested that the role of antiphospholipid antibodies as an etiological factor for spinal cord ischemia should be recognized among causes that might have been categorized as either spontaneous spinal cord infarction or myelitis.
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PMID:Spinal cord infarction associated with primary antiphospholipid syndrome in a young child. Case report. 836 Jul 45

A 31-year-old woman with systemic lupus erythematosus (SLE) developed meningoencephalitis, followed by transverse myelitis. The clinical picture was otherwise not consistent with a lupus flare. Extensive diagnostic evaluation was unrevealing. Acute visual loss ensued, associated with an unusual pattern of retinitis. Endoretinal biopsy established the diagnosis of herpesvirus infection. Reinstitution of antiviral therapy, and optic nerve sheath decompression, led to resolution of neurologic deficits and partial return of vision. Our report is the first that describes a patient with SLE with herpes meningoencephalitis, transverse myelitis, and rapidly progressive outer retinal necrosis, diagnosed antemortem by endoretinal biopsy, and successfully treated with acyclovir and optic nerve fenestration.
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PMID:Central nervous system herpesvirus infection in systemic lupus erythematosus: diagnosis by endoretinal biopsy. 839 32

Spinal epidural abscess is a rare infection that is usually treated with surgery and antibiotics. A small number of patients have been treated with medical therapy alone. We review several recent series of spinal epidural abscess and discuss the controversy surrounding the use of medical therapy alone. We also review recent clinical and pathogenetic data about human T-lymphotropic virus type 1 infection. The role of magnetic resonance imaging in the diagnosis of intramedullary spinal cord abscess, and methylprednisolone and cyclophosphamide treatment of transverse myelitis in systemic lupus erythematosus are also discussed briefly.
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PMID:Myelitis and toxic, inflammatory, and infectious disorders. 840 Apr 70

Anticardiolipin antibodies (aCL) were studied in relation to pulmonary hypertension (PH) in 22 patients with mixed connective tissue disease (MCTD) or systemic lupus erythematosus (SLE). The mean pulmonary arterial pressure (mPAP) values were similar in the 12 MCTD and 10 SLE patients: 26 +/- 11 and 25 +/- 11 mm Hg, respectively. However, the frequency of PH was higher in SLE (60%) than in MCTD patients (33%). The titers of aCL were significantly higher in SLE (38 +/- 27 IU/ml) than in MCTD (17 +/- 7 IU/ml; p < 0.02). Two SLE patients with high titers of aCL had multiple cerebral infarction and transverse myelitis, and deep vein thrombosis, respectively. A significant correlation between the titers of aCL and mPAP was observed in patients with MCTD (p < 0.05), but not in patients with SLE.
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PMID:Anticardiolipin antibodies are associated with pulmonary hypertension in patients with mixed connective tissue disease or systemic lupus erythematosus. 848 53

Transverse myelitis has been cited as a rare and unusual complication of systemic lupus erythematosus (SLE). A review of the literature reveals only 10 cases of transverse myelitis as the initial presentation of SLE, and only one with reported benefits from antimalarial therapy. The case of a 30-year-old woman is reviewed. She presented to the emergency room with complaints of hypogastric and low back pain. The ensuing course was one of frank urinary retention and rapidly progressing quadriparesis. Magnetic resonance imaging of the spine revealed marked edema of the cervical and thoracic spine. A diagnosis of SLE was based on positive antinuclear antibodies and leukopenia. The patient was treated with high dose methylprednisolone, plasmapheresis and pulse cyclophosphamide for 3 months. Subsequently, treatment was begun with hydroxychloroquine, and significant improvement in her neurologic and functional status was achieved after 1 month of therapy. Ten months after her onset of symptoms, the patient suffered an acute exacerbation of paraparesis and urinary retention. Again, she improved clinically after high dose methylprednisolone and pulse cyclophosphamide for 1 month. Hydroxychloroquine was continued throughout the duration of therapy.
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PMID:Transverse myelitis complicating systemic lupus erythematosus: treatment including hydroxychloroquine. Case report. 851 79

We report the clinical case of an 8 years female with systemic lupus erythematosous who developed transverse myelitis secondary to antiphospholipid syndrome. She had an excellent response to the treatment with Prednisone and Cyclophosphamide. As long as we know this is the first report of transverse myelitis as clinical manifestation of antiphospholipid syndrome in childhood.
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PMID:[Transversal myelitis as initial manifestation of secondary antiphospholipid syndrome. Report of a case]. 852 83

Myelopathy is a rare central nervous system manifestation in systemic lupus erythematosus (SLE). We present a case of SLE, who developed motor paralytic bladder and various other neurological abnormalities. A 29-year-old female with SLE was admitted to our hospital because of complete dysuria without any troubles on defecation. Accelerated hypertension had been noticed 2 weeks before the admission. Physical examinations revealed that she had muscle weakness in right brachial biceps, bilateral carpal extensor and flexor, and flexor muscles of bilateral lower extremities. Slight sensory disturbance was present on her soles. Bilateral Chaddok and Babinski's signs were positive. Electromyographic studies including nerve conduction velocities of her limbs were normal, however, neurogenic discharges were observed in anal sphincter muscles. Cystometry demonstrated atonic bladder, but any pathological findings such as lupus cystitis and interstitial cystitis were not observed in the biopsied specimens from her bladder. Antibodies to single-stranded DNA, U1 RNP, Sm and SS-A/Ro were positive in her serum, and lupus anticoagulant and anticardiolipin antibodies (IgG) were also detected. In her cerebral spinal fluid (CSF), elevated protein level and albuminocytologic dissociation were recognized, while glucose level was low. Magnetic resonance imaging (MRI) study detected high signal intensities in the inner part of medulla oblongata and in the spinal cord at second lumbar spine level. After two courses of methyl-prednisolone pulse therapy, the patient's neurological symptoms including dysuria had completely recovered and abnormal findings previously observed on MRI had also disappeared. After 7 months of the episode, she became normotensive. The proteins and glucose levels in her CSF had gradually returned to normal. Among patients with SLE, correlations of antiphospholipid antibodies with myelitis/myelopathy or accelerated hypertension have been reported. Therefore, possible roles of antiphospholipid antibodies were considered in the pathogenesis of neurologic abnormalities observed in our patient. In addition, low glucose level in CSF might be a good indicator for the diagnosis of lupus-associated myelopathy.
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PMID:[A case of systemic lupus erythematosus with various central and peripheral neurological disorders presenting with motor paralytic bladder as a major manifestation]. 859 61

We describe a 13-year-old female patient with systemic lupus erythematosus (SLE) who presented with acute transverse myelitis (ATM) in the course of SLE. IgG and IgM anticardiolipin antibodies (aCL) were positive at moderate titers. Magnetic resonance imaging (MRI) of the thoracic spine demonstrated decreased signal intensity and diffuse edema of the spinal cord from T2 to T6 on T1-weighted images. Dramatic clinical improvement of the neurologic impairment was noted a few days after high dose intravenous (IV) methylprednisolone (MP) and cyclophosphamide (Cy). Herein we further emphasize the benefit of IV MP and Cy in ATM and the relationship between ATM and antiphospholipid antibodies (aPLA) in SLE.
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PMID:Successful treatment of transverse myelitis in a child with systemic lupus erythematosus. 867 25

A woman with systemic lupus erythematosus (SLE) presented with a zoster eruption. Transverse myelitis developed at the site of the dermatomal distribution of the rash. SLE and varicella zoster virus (VZV) can both cause myelitis, and are difficult to differentiate. The topographic association between the cutaneous and the neurological involvement suggesting VZV myelitis was confirmed by polymerase chain reaction (PCR) for VZV in the cerebrospinal fluid. This case illustrates the potential role of the selective amplification of VZV DNA in cerebrospinal fluid to diagnose central neurological complications associated with VZV. The value of magnetic resonance imaging of the spinal cord in the evaluation of patients with myelitis is emphasized.
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PMID:Herpes zoster myelitis occurring during treatment for systemic lupus erythematosus. 883 1

A case of acute transverse myelitis following primary antiphospholipid syndrome was presented. The patient was 32-year-old Japanese female who was admitted to our hospital with paresthesia and weakness of the right upper extremity in September 1995. Neurological examinations revealed slight weakness and hypesthesia of the right arm and leg, impairment of vibration sense below the right knee, and hyperreflexia on the right side. There was no apparent history of systemic lupus erythematosus or multiple sclerosis. Laboratory investigations disclosed raised anticardiolipine antibody level of the IgG class. A magnetic resonance (MR) imaging of the cervical spine revealed changes in the spinal cord at C3-5. A gradual enlargement of the cord at C3-5 level was revealed on T1-weighted sagittal images; increased signal intensity at these same levels was visualized on T2-weighted images. Following administration of contrast material, an area of increased signal intensity was visualized within the cord extending from the C3/4 level to the C4/5 level in sagittal views and was located in the right lateral and posterior funiculus of the cord in axial views. After the admission, the patient's neurological symptoms worsened, and then we treated her by steroid pulse therapy. After that, the patient's symptoms gradually disappeared and the abnormal signal intensity of the spinal cord on an MR imaging disappeared. No evidence of recurrence was yielded by neurological examinations or neuroimaging studies. Antiphospholipid antibodies should be studied in all patients with transverse myelitis whether known to systemic lupus erythematosus, multiple sclerosis or not.
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PMID:[Transverse myelitis in a patient with primary antiphospholipid syndrome--a case report]. 888 35


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