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Query: UMLS:C0024141 (systemic lupus erythematosus)
 44,322 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A review is made of the literature on central nervous system involvement in systemic lupus erythematosus (CNS-SLE). Particular attention is focused on lupus myelopathy. Referring to two well-documented personal cases, the authors describe the characteristic multisystem involvement, protean clinical pattern, serum and cerebrospinal fluid changes, histoimmunologic findings, response to corticosteroids and immunosuppressive agents and some prognostic features.
Paraplegia 1979 Sep
PMID:Spinal cord involvement in systemic lupus erythematosus. 50 67

Two patients with sudden onset of myelopathy associated with Systemic Lupus Erythematosus (Erythema Nodosum) are described. Pertinent literature is extensively reviewed and these two new patients are added to previously reported 26 patients.
Paraplegia 1978 Nov
PMID:Myelopathy associated with systemic lupus erythematosus (erythema nodosum). 73 10

This study presents the case of a 32 year-old patient carrying a belatedly diagnosed systemic lupus erythematosus (SLE), who suddenly developed transverse myelitis. This complication had been preceded a few hours earlier by a sole neurological disorder consisting in a universal nystagmus. This neurological condition was accompanied by a renal syndrome revealed by a nephritic sediment with scarce functional repercussions. The patient was treated with a combination of high doses of methylprednisone and cyclophosphamide. The central neurological and renal disorder remitted, but it was impossible to reverse the patient's paraplegia, which became permanent. This paper includes a review of the 46 cases of transverse myelitis and SLE published so far with regard to diagnosis, treatment and results, a comparison with the case under study, and the conclusions drawn.
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PMID:[Transverse myelitis and systemic lupus erythematosus. A case report]. 182 26

A clinical history typical of multisclerosis began in a 20-year old man with transient, then permanent manifestations involving the optic tract and the pyramidal, extrapyramidal and cerebellar systems. The patient died at the age of 62, at the end-stage of a complex clinical situation which included paraplegia, bilateral cerebellar syndrome, optic nerve atrophy, epileptic seizures and dementia. When the patient was 54 years old, laboratory findings suggestive of systemic lupus erythematosus (SLE) were discovered, namely: antinuclear, native anti-DNA, anti-Sm antibodies, circulating anticoagulant, cryoglobulinaemia and low complement level. These abnormalities persisted up to the patient's death, 8 years later, without any non-neurological sign of SLE. Post-mortem examination showed lesions of focal demyelination characteristic of multiple sclerosis, but no evidence of cerebral or extracerebral SLE. This case raises the problem of borderlines or associations between systemic lupus erythematosus and multiple sclerosis. In our case, as in other cases of "lupoid sclerosis" reported in the literature, there was a frank and isolated elevation of serum IgM levels.
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PMID:[Multiple sclerosis associated with biological symptoms of systemic lupus erythematosus. A case with anatomical study]. 248 95

At 20 year-old a patient developed a paraplegia which regressed within several months, suggestive of an acute myelitis. Subsequently, several episodes of spastic paraplegia, posterior tracts lesions and retrobulbar optic neuritis, a transient cerebellar syndrome, modifications in cerebrospinal fluid (pleiocytosis, hypergammaglobulin levels, elevated Delpech's ratio) suggested multiple sclerosis. When aged 62 years, the patient developed articular lesions, Raynaud's phenomenon, and buccal ulcers attributed to lupus. LE cells, native DNA anti-antibodies, anti-Sm auto antibodies on immunofluorescence were present. The possibility of a collagen disease, expressed initially and for a long period in an exclusively neurological disorder is discussed. It was considered, however, to be more likely two distinct affections. This association has been reported very rarely, even though two immunity-mediated inflammatory affections are involved.
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PMID:[Multiple sclerosis and lupus]. 609 17

A 77-year-old woman developed recurrent transverse myelopathy of the thoracic cord about a year after acute retrobulbar optic neuropathy on the left. Neurological examination revealed paraplegia, total sensory loss down from the level of the sixth thoracic cord and sphincteric disturbances. Her clinical features resembled multiple sclerosis, but magnetic resonance imaging (MRI) of the brain and spinal cord revealed no evidence of demyelination or inflammation. MRI of the brain showed the tentorium cerebelli on the right of low signal in T1- and T2-weighted images with marked enhancement by gadolinium, indicating pachymeningitis. Characteristically, perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) together with antinuclear antibody was positive, whereas lupus anticoagulant and anti-cardiolipin antibody were negative. A high dose of corticosteroid including pulse therapy did not improve her symptoms. In the present case, the optic neuropathy, recurrent transverse myelopathy and hypertrophic pachymeningitis may have been caused by some common inflammatory processes related with p-ANCA.
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PMID:[A case of optic neuropathy, recurrent transverse myelopathy and hypertrophic pachymeningitis associated with perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA)]. 766 20

A 69-year-old woman was admitted to our hospital with a 7-month history of sensory disturbance of the bilateral lower extremities. Since she developed paraplegia of the extremities, urinary incontinence and left hemiplegia several days after admission, neurologic involvement both in the lumbar cord, and in the cervical cord or the brain was suspected. While no abnormalities were noted by computerized tomography of the brain. T2-weighted magnetic resonance imaging (MRI) clearly demonstrated foci in the periventricular and the basal ganglia regions bilaterally. Furthermore, the levels of immunoglobulin G and interleukin 6 were increased in the cerebrospinal fluid (CSF). From physical and other laboratory findings in addition to the MRI and CSF findings, she was diagnosed as having systemic lupus erythematosus with central nervous involvement. The administration of prednisolone resulted in marked improvement in her neurologic symptoms in two months. Thus, it is considered that the MRI and CSF examinations are useful for the diagnosis and treatment of central nervous involvement of systemic lupus erythematosus.
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PMID:[Magnetic resonance imaging and cerebrospinal fluid examinations in a case of central nervous involvement of systemic lupus erythematosus]. 793 61

Central nervous system involvement in systemic lupus erythematosus (SLE) is frequent and severe, however, myelopathy is rarely reported (0.8 p. 100 of SLE cases). We describe two SLE-young women. They were 21 and 37 year old, presented with acute paraplegia. CSF study showed pleocytosis and moderately elevated protein. Antinuclear, anti-DNA and anticardiolipin were positive. High dose steroids therapy induced marked improvement. The pathogenesis of myelopathy in SLE remains unclear. Anti-phospholipid antibodies may cause thrombosis and ischemic myelopathy. However, auto-antibodies directed against central nervous system constituents may be involved.
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PMID:[Lupic spinal cord diseases and antiphospholipid antibodies]. 929 27

We report a 38-year-old man systemic lupus erythematosus who presented with an acute onset of paraplegia and urinary retention. The man had a 12-year history of nodular cutaneous mucinosis and arthralgia. In 1994, he was admitted to our hospital with a sudden onset of weakness and numbness of the right leg followed by an emergence of similar symptoms in the left leg. His elder sister had died at 16 years of age after suffering from systemic lupus erythematosus for 6 years. On examination, the patient had skin rash on his chest, back, head, forehead, and extremities. The neurological examination revealed that his tongue deviated to the right on protrusion. The muscle power was reduced to 2-3/5 in the right leg and to 4/5 in the left leg. The sensory disturbance was noted in the lower extremities with predominant involvement of the right leg. Reflexes were increased in the right biceps, triceps, both patellas, and Achilles tendons. Babinski sign was noted bilaterally. Urinary retention and constipation were also noted. The results of the blood cell count and hepatic and renal function tests were normal. Serum levels of C-reactive protein and complements (C3, C4, CH50) were also normal. Serological examinations showed increased anti-DNA antibody (14 U/ml, [normal, < 6]). Antinuclear antibody was positive at a titer of 1:1380. CSF study showed an increased protein concentration of 83 mg/dl and an IgG level of 14 mg/dl with a normal number of cells. MR images revealed a T1-low, T2-high signal lesion at the upper part of the left ventral medulla. MR images of the brain and spinal cord were normal. The patient was diagnosed as having SLE. High-dose intravenous methylprednisolone (1 g/day) pulse treatment that was started 25 days after the onset of neurological symptoms, produced partial relief. Our case presented with paraplegia with a focal lesion in the left upper ventral part of the medulla on MR images. The incidence of male SLE is low, and paraplegia is a rare complication of SLE. Thus, the medullary lesion in SLE observed in our case appears to be rare. SLE should be considered as a cause of acute onset paraplegia or myelopathy.
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PMID:[A man with systemic lupus erythematosus presenting with spastic paraplegia]. 936 89

A 47 year-old Japanese female who showed transverse myelopathy (TM) due to spinal epidural hematoma diagnosed by MRI in the course of systemic lupus erythematosus (SLE) was reported. She was admitted to Keio University Hospital due to paraplegia, anesthesia of lower extremity, urinary disturbance. Neurological examination revealed transverse disturbance of Th 10. Lumbar spinal cord MRI showed irregular mass that located at epidural region of 9th-11th thoracic vertebrae. When the laminectomy of 9th-11th thoracic vertebrae was performed, hematoma (4.5 cm x 1.5 cm in size) was confirmed and removed completely. Post operative condition was stable and symptoms had been improving gradually. It has been reported that TM associated with SLE was closely related to myelitis. In this case, epidural hematoma was a major cause of TM and MRI was very useful for her diagnosis and treatment. This is the rare case of SLE associated with spinal epidural hematoma and was thought as a important case to consider the cause of neurological complication of SLE.
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PMID:[A case of systemic lupus erythematosus associated with spinal epidural hematoma]. 979 78


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