Myelopathy in systemic lupus erythematosus: clinical, laboratory, radiological and progression findings in a cohort of 1,193 patients

Detalhes bibliográficos
Autor(a) principal: Costallat,Beatriz Lavras
Data de Publicação: 2016
Outros Autores: Ferreira,Daniel Miranda, Costallat,Lilian Tereza Lavras, Appenzeller,Simone
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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spelling 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
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dc.relation.none.fl_str_mv 10.1016/j.rbre.2016.03.006
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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)
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reponame_str Revista Brasileira de Reumatologia (Online)
collection Revista Brasileira de Reumatologia (Online)
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