Produção Nacional
Revisado por pares
Transverse Myelitis in Systemic Lupus Erythematosus
2020; Lippincott Williams & Wilkins; Volume: 27; Issue: 6S Linguagem: Inglês
10.1097/rhu.0000000000001322
ISSN1536-7355
AutoresEdson Chiganer, Carmen Lessa, José Luis Di Pace, Mónica Perassolo, Edgar Carnero Contentti, Lucas Alessandro, Jorge Correale, María Fernanda Farfan, Graciana Lourdes Galiana, Marvin Sánchez Benavides, Franco Pacello, Mauro Stagno, Analía Cardozo, María Belén Nacimiento Cantero, Juan Gabriel Elizaur López, Pedro Daniel Delgadillo, Patricia Melgarejo, I. Acosta-Colman, Marcos Aurelio Vázquez Báez, Edgar Patricio Correa Díaz, Elisa Carolina Jácome Sánchez, Magaly Alva Linares, Erick Adrian Zamora Tehozol, Hilda Fragoso-Loyo, Lauro Quintanilla-González, José Antonio de Jesús Batún-Garrido, Emília Inoue Sato, Edgard Torres do Reis-Neto, María Angela Carreño Nigro, Javier Hryb,
Tópico(s)Peripheral Neuropathies and Disorders
ResumoAcute transverse myelitis (ATM) is an infrequent but severe complication of systemic lupus erythematosus (SLE). The purpose of study was to describe clinical features and prognostic factors of patients with SLE-related ATM.In this medical records review study, data were collected from 60 patients from 16 centers seen between 1996 and 2017 who met diagnostic criteria for SLE and myelitis as defined by the American College of Rheumatology/Systemic International Collaborating Clinics and the Working Group of the Transverse Myelitis Consortium, respectively. Objective neurological impairment was measured with American Spinal Injury Association Impairment Scale (AIS) and European Database for Multiple Sclerosis Grade Scale (EGS).Among patients included, 95% (n = 57) were female, and the average age was 31.6 ± 9.6 years. Myelitis developed after diagnosis of SLE in 60% (n = 36). Symmetrical paraparesis with hypoesthesia, flaccidity, sphincter dysfunction, AIS = A/B, and EGS ≥ 8 was the most common presentation. Intravenous methylprednisolone was used in 95% (n = 57), and 78.3% (n = 47) received intravenous cyclophosphamide. Sensory/motor recovery at 6 months was observed in 75% (42 of 56), but only in 16.1% (9 of 56) was complete. Hypoglycorrhachia and EGS ≥ 7 in the nadir were associated with an unfavorable neurological outcome at 6 months (p < 0.05). A relapse rate during follow-up was observed in 30.4% (17 of 56). Hypoglycorrhachia and hypocomplementemia seem to be protective factors for relapse. Intravenous cyclophosphamide was associated with time delay to relapse.Systemic lupus erythematosus-related ATM may occur at any time of SLE course, leading to significant disability despite treatment. Relapses are infrequent and intravenous cyclophosphamide seems to delay it. Hypoglycorrhachia, hypocomplementemia, and EGS at nadir are the most important prognostic factors.
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