1/37. MR imaging of acute transverse myelitis.magnetic resonance imaging has proven to be useful in the diagnosis of spinal cord pathology. Little has been written in the literature concerning magnetic resonance imaging of acute transverse myelitis. A case of magnetic resonance imaging of acute transverse myelitis in a young man with known systemic lupus erythematosus is presented along with a review of the radiographic approach to transverse myelitis.- - - - - - - - - - ranking = 1keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
2/37. Involvement of the entire spinal cord and medulla oblongata in acute catastrophic-onset transverse myelitis in SLE.A 30-year-old Caucasian male with systemic lupus erythematosus suffered acute catastrophic-onset transverse myelitis. Two years earlier aseptic meningitis, another rare CNS lupus manifestation, had been diagnosed. MRI showed involvement of the medulla oblongata and the entire spinal cord. Therapy with intravenous high-dose methylprednisolone and intravenous cyclophosphamide is discussed.- - - - - - - - - - ranking = 1keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
3/37. Longitudinal myelitis associated with systemic lupus erythematosus: clinical features and magnetic resonance imaging of six cases.Myelopathy is a rare central nervous system (CNS) complication associated with systemic lupus erythematosus (SLE). Acute transverse myelitis (ATM) is the most frequent form of SLE-related myelopathy. magnetic resonance imaging (MRI) typically shows increased signal intensity in T2-weighted images and cord swelling. In the present paper, we describe six cases of SLE-related myelopathy with multiple increased signals in the T2-weighted images involving continuous levels of the cervical and thoracic spinal cord, a distinctive feature recently named 'longitudinal myelitis'. The clinical and laboratory findings are similar to those presented by ATM patients, including paraparesis, sensory level and sphincter disturbances. Four patients had positive antiphospholipid antibodies (aPL) suggesting that this could be a characteristic of longitudinal myelitis. Treatment in all cases included high doses of corticosteroids and immunosuppressive agents (intravenous (i.v.) cyclophosphamide). Anticoagulation therapy was given to one patient and two others received low doses of aspirin. The outcome was mainly unfavorable with slow improvement in only one case, no improvement in two and relapse of the myelopathy in the remaining three. In conclusion, longitudinal myelitis is an unusual form of SLE-related myelopathy, it might be associated with aPL and it has a poor prognosis.- - - - - - - - - - ranking = 5keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
4/37. Systemic lupus erythematosus related transverse myelitis presenting longitudinal involvement of the spinal cord.Lupus-related transverse myelitis is a rare but serious complication. A 25-year-old Japanese woman with systemic lupus erythematosus (SLE) was admitted because of numbness of the face and left upper extremity, headache, and intermittent fever. Six days later, she developed tetraplegia. MRI of the spinal cord showed longitudinal high intensity signals from medulla oblongata to C5, and from Th12 to conus medullaris on T2-weighted image. These MRI findings were consistent with acute catastrophic neurological abnormalities. Despite administration of the combination of methylprednisolone and cyclophosphamide pulse therapies, as well as plasmapheresis, her condition did not improve. Any vasculopathy in addition to the autoimmune pathogenesis, and narrow therapeutic window may relate to the present refractory case.- - - - - - - - - - ranking = 4.1425691077403keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
5/37. Effect of selective posterior rhizotomy on transverse myelitis in a patient with systemic lupus erythematosus.This report describes the case of a 26-yr-old man experiencing transverse myelitis, a rare but serious complication of systemic lupus erythematosus occurring in less than 1% of patients with systemic lupus erythematosus, 4 yr after the onset of systemic lupus erythematosus. Significant neurologic deficits, including spastic paraplegia, dysthetic pain, and impaired bladder control, which made him completely bedridden and dependent in activities of daily living, continued, despite his immediate diagnosis and treatment. The patient received bilateral L1 to S1 selective posterior rhizotomy 1 yr after the onset of transverse myelitis, and 10 mo after selective posterior rhizotomy, he was completely independent in ambulation and self-care, demonstrating that selective posterior rhizotomy can be safely performed and its goals achieved under different medical conditions, as long as thorough preoperative evaluation and every possible precaution have been taken.- - - - - - - - - - ranking = 7keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
6/37. Transverse myelitis in patients with antiphospholipid antibodies--the importance of early diagnosis and treatment.Transverse myelitis (TM) is a rare manifestation of systemic lupus erythematosus (SLE) and the antiphospholipid syndrome (APS). No uniform therapeutic protocol exists for its treatment, and the prognosis is usually poor. Here we describe four patients having TM associated with antiphospholipid antibodies. Treatment measures and delay in diagnosis between symptom onset and the initiation of treatment varied between patients, but the earlier the diagnosis and the more aggressive the treatment the better was the patient's outcome. Based on these cases and on a literature review we suggest that early aggressive treatment (usually with pulses of methylprednisolone and cyclophosphamide) might improve the prognosis of patients with TM associated with antiphospholipid antibodies.- - - - - - - - - - ranking = 1keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
7/37. Transverse myelitis associated with chronic hepatitis c.An infectious etiology is one of the postulated mechanisms for autoimmune diseases. An emergence of autoimmune phenomena associated with hepatitis c virus (HCV) infection has been reported. Transverse myelitis is an inflammatory disease of the spinal vasculature attributed to viral infections and to autoimmune diseases including systemic lupus erythematosus and the antiphospholipid syndrome. A 34-year-old male was admitted for the rapid onset of numbness of the lower extremities and urinary retention. His past history included hepatitis c infection. The neurological examination and MRI of the thoracic spine confirmed the diagnosis of transverse myelitis. Abnormal laboratory results were hyperglobulinemia, abnormal liver function tests, and positive ANF, anti-dsDNA antibodies, and p and c-ANCA. The patient was treated with high dose prednisone, then tapered to a low dose, but regained only partial neurological function after 15 months of prednisone therapy. Persistent neurological deficits and elevated ANF and ANCA were present at a follow-up of 30 months. We describe the first reported case of a patient with chronic HCV who developed transverse myelitis.- - - - - - - - - - ranking = 1keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
8/37. Transverse myelitis in a patient with primary antiphospholipid syndrome.The neurological manifestations of antiphospholipid syndrome (APS) are diverse. Transverse myelitis (TM) is an uncommon, but well-known neurological complication of systemic lupus erythematosus (SLE). On the other hand, the reported cases associated with primary APS are extremely rare. To our knowledge, this is the first report of TM in a patient with primary APS in korea. A 32-year-old male patient was admitted with the sudden onset of numbness, a tingling sensation, and weakness in both lower extremities. He had a 19 months history of external iliac and femoral arterial thromboses prior to admission. The laboratory results indicated the presence of anticardiolipin antibodies of the IgG class and lupus anticoagulant. No other autoantibodies were detected and there were no apparent clinical manifestations of SLE or multiple sclerosis. A T2-weighted magnetic resonance (MR) image showed swelling and increased intensity of the cervical and thoracic spinal cord between C6 and T7 with slight enhancement by contrast medium. After steroid pulse therapy, the patient's symptoms were gradually relieved and the abnormal findings on MR imaging disappeared.- - - - - - - - - - ranking = 1keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
9/37. Recurrent transverse myelitis in primary antiphospholipid syndrome--case report and literature review.Transverse myelitis is an uncommon but well-known neurologic complication of systemic lupus erythematosus, and antiphospholipid antibodies have been implicated as having a pathogenic role of myelopathy in primary and secondary antiphospholipid syndrome. Transverse myelitis usually is monophasic, but recurrent transverse myelitis was reported in association with systemic lupus erythematosus, multiple sclerosis, and spinal arteriovenous malformations. It has been reported extremely rarely in patients with primary antiphospholipid syndrome. Herein we describe a patient with both conditions and propose that recurrent transverse myelitis should be included as a very rare feature of primary antiphospholipid syndrome.- - - - - - - - - - ranking = 2keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
10/37. Transverse myelitis and chronic urticaria in systemic lupus erythematosus. Case report.We report a 40 years old woman with chronic urticaria and acute transverse myelitis associated with systemic lupus erythematosus. The urticaria appeared in her adolescence and after 26 years was followed by photosensitivity, peripheral polyarthritis and acute transverse myelitis, with positive antiphospholipid and antinuclear antibodies. Both chronic urticaria and acute transverse myelitis have been described associated with or appearing as the first manifestation of systemic lupus erythematosus. Transverse myelitis is a rare and still poorly understood condition reported in about 2% of patients with systemic lupus.- - - - - - - - - - ranking = 6.0427567884745keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
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