Myelopathy in systemic lupus erythematosus: clinical, laboratory, radiological and progression findings in a cohort of 1,193 patients
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista Brasileira de Reumatologia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0482-50042016000300240 |
Resumo: | Abstract Objective To describe clinical, laboratory, radiological and progression characteristics of myelopathy in systemic lupus erythematosus (SLE). Patients and methods A retrospective analysis was performed on a cohort of 1193 patients with SLE (ACR criteria) in order to identify patients with myelopathy (neuropsychiatric ACR). Disease activity was assessed by the SLE activity index (SLEDAI) on the date of the event and functional capacity was assessed by the Expanded Disability Status Scale (EDSS) at the last visit. Results We identified 14 (1.2%) patients with myelopathy. All were women with a mean age of 30 ± 11.5 years. Myelopathy occurred at the diagnosis of SLE in four (28%) patients; and nine (64%) patients had another type of neuropsychiatric manifestation associated. Neurological recurrence was observed in one (7%) patient. Disease activity was observed in 2 (14%) patients. Cerebrospinal fluid presented pleocytosis on 7 (53%) patients; antiphospholipid antibodies were positive in 5 (45%). Magnetic resonance imaging (MRI) showed T2 hyperintensity with a predominance of longitudinal involvement in 6 (86%) patients. Most were treated with intravenous corticosteroids and cyclophosphamide. No patient had full recovery and four (36%) had high EDSS scores. Three (21%) patients died from sepsis early in the course of their myelopathy, during or after immunosuppressive therapy. Conclusions Myelopathy occurred in 14 (1.2%) of the patients in our cohort and this may be the first manifestation of the disease occurring independently of systemic disease activity. Although rare, myelopathy shows great morbidity and mortality, can be recurrent and MRI is critical for diagnosis. |
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Myelopathy in systemic lupus erythematosus: clinical, laboratory, radiological and progression findings in a cohort of 1,193 patientsSystemic lupus erythematosusMyelopathyTransverse myelitisMagnetic resonanceAbstract Objective To describe clinical, laboratory, radiological and progression characteristics of myelopathy in systemic lupus erythematosus (SLE). Patients and methods A retrospective analysis was performed on a cohort of 1193 patients with SLE (ACR criteria) in order to identify patients with myelopathy (neuropsychiatric ACR). Disease activity was assessed by the SLE activity index (SLEDAI) on the date of the event and functional capacity was assessed by the Expanded Disability Status Scale (EDSS) at the last visit. Results We identified 14 (1.2%) patients with myelopathy. All were women with a mean age of 30 ± 11.5 years. Myelopathy occurred at the diagnosis of SLE in four (28%) patients; and nine (64%) patients had another type of neuropsychiatric manifestation associated. Neurological recurrence was observed in one (7%) patient. Disease activity was observed in 2 (14%) patients. Cerebrospinal fluid presented pleocytosis on 7 (53%) patients; antiphospholipid antibodies were positive in 5 (45%). Magnetic resonance imaging (MRI) showed T2 hyperintensity with a predominance of longitudinal involvement in 6 (86%) patients. Most were treated with intravenous corticosteroids and cyclophosphamide. No patient had full recovery and four (36%) had high EDSS scores. Three (21%) patients died from sepsis early in the course of their myelopathy, during or after immunosuppressive therapy. Conclusions Myelopathy occurred in 14 (1.2%) of the patients in our cohort and this may be the first manifestation of the disease occurring independently of systemic disease activity. Although rare, myelopathy shows great morbidity and mortality, can be recurrent and MRI is critical for diagnosis.Sociedade Brasileira de Reumatologia2016-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0482-50042016000300240Revista Brasileira de Reumatologia v.56 n.3 2016reponame:Revista Brasileira de Reumatologia (Online)instname:Sociedade Brasileira de Reumatologia (SBR)instacron:SBR10.1016/j.rbre.2016.03.006info:eu-repo/semantics/openAccessCostallat,Beatriz LavrasFerreira,Daniel MirandaCostallat,Lilian Tereza LavrasAppenzeller,Simoneeng2016-06-23T00:00:00Zoai:scielo:S0482-50042016000300240Revistahttp://www.scielo.br/scielo.php?script=sci_serial&pid=0482-5004&lng=pt&nrm=isoONGhttps://old.scielo.br/oai/scielo-oai.php||sbre@terra.com.br1809-45700482-5004opendoar:2016-06-23T00:00Revista Brasileira de Reumatologia (Online) - Sociedade Brasileira de Reumatologia (SBR)false |
dc.title.none.fl_str_mv |
Myelopathy in systemic lupus erythematosus: clinical, laboratory, radiological and progression findings in a cohort of 1,193 patients |
title |
Myelopathy in systemic lupus erythematosus: clinical, laboratory, radiological and progression findings in a cohort of 1,193 patients |
spellingShingle |
Myelopathy in systemic lupus erythematosus: clinical, laboratory, radiological and progression findings in a cohort of 1,193 patients Costallat,Beatriz Lavras Systemic lupus erythematosus Myelopathy Transverse myelitis Magnetic resonance |
title_short |
Myelopathy in systemic lupus erythematosus: clinical, laboratory, radiological and progression findings in a cohort of 1,193 patients |
title_full |
Myelopathy in systemic lupus erythematosus: clinical, laboratory, radiological and progression findings in a cohort of 1,193 patients |
title_fullStr |
Myelopathy in systemic lupus erythematosus: clinical, laboratory, radiological and progression findings in a cohort of 1,193 patients |
title_full_unstemmed |
Myelopathy in systemic lupus erythematosus: clinical, laboratory, radiological and progression findings in a cohort of 1,193 patients |
title_sort |
Myelopathy in systemic lupus erythematosus: clinical, laboratory, radiological and progression findings in a cohort of 1,193 patients |
author |
Costallat,Beatriz Lavras |
author_facet |
Costallat,Beatriz Lavras Ferreira,Daniel Miranda Costallat,Lilian Tereza Lavras Appenzeller,Simone |
author_role |
author |
author2 |
Ferreira,Daniel Miranda Costallat,Lilian Tereza Lavras Appenzeller,Simone |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Costallat,Beatriz Lavras Ferreira,Daniel Miranda Costallat,Lilian Tereza Lavras Appenzeller,Simone |
dc.subject.por.fl_str_mv |
Systemic lupus erythematosus Myelopathy Transverse myelitis Magnetic resonance |
topic |
Systemic lupus erythematosus Myelopathy Transverse myelitis Magnetic resonance |
description |
Abstract Objective To describe clinical, laboratory, radiological and progression characteristics of myelopathy in systemic lupus erythematosus (SLE). Patients and methods A retrospective analysis was performed on a cohort of 1193 patients with SLE (ACR criteria) in order to identify patients with myelopathy (neuropsychiatric ACR). Disease activity was assessed by the SLE activity index (SLEDAI) on the date of the event and functional capacity was assessed by the Expanded Disability Status Scale (EDSS) at the last visit. Results We identified 14 (1.2%) patients with myelopathy. All were women with a mean age of 30 ± 11.5 years. Myelopathy occurred at the diagnosis of SLE in four (28%) patients; and nine (64%) patients had another type of neuropsychiatric manifestation associated. Neurological recurrence was observed in one (7%) patient. Disease activity was observed in 2 (14%) patients. Cerebrospinal fluid presented pleocytosis on 7 (53%) patients; antiphospholipid antibodies were positive in 5 (45%). Magnetic resonance imaging (MRI) showed T2 hyperintensity with a predominance of longitudinal involvement in 6 (86%) patients. Most were treated with intravenous corticosteroids and cyclophosphamide. No patient had full recovery and four (36%) had high EDSS scores. Three (21%) patients died from sepsis early in the course of their myelopathy, during or after immunosuppressive therapy. Conclusions Myelopathy occurred in 14 (1.2%) of the patients in our cohort and this may be the first manifestation of the disease occurring independently of systemic disease activity. Although rare, myelopathy shows great morbidity and mortality, can be recurrent and MRI is critical for diagnosis. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-06-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0482-50042016000300240 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0482-50042016000300240 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1016/j.rbre.2016.03.006 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Reumatologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Reumatologia |
dc.source.none.fl_str_mv |
Revista Brasileira de Reumatologia v.56 n.3 2016 reponame:Revista Brasileira de Reumatologia (Online) instname:Sociedade Brasileira de Reumatologia (SBR) instacron:SBR |
instname_str |
Sociedade Brasileira de Reumatologia (SBR) |
instacron_str |
SBR |
institution |
SBR |
reponame_str |
Revista Brasileira de Reumatologia (Online) |
collection |
Revista Brasileira de Reumatologia (Online) |
repository.name.fl_str_mv |
Revista Brasileira de Reumatologia (Online) - Sociedade Brasileira de Reumatologia (SBR) |
repository.mail.fl_str_mv |
||sbre@terra.com.br |
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1750318051420536832 |