Clinical characteristics of transverse myelitis combined with systemic lupus erythematosus

Abstract

Background & Objectives : Transverse myelitis can be accompanied with systemic lupus erythematosus (SLE), which is known as lupoid sclerosis. We report 4 patients consistent with the diagnosis of lupoid sclerosis and describe the clinical characteristics of this syndrome in our cases. Method : All patients was proven as SLE with appropriate serologic test, for example ANA, Anti-dsDNA antibody, C3. C4 level, antiphospholipid antibody, and LE cell. The sex was female in all patients and age distribution was 15 to 36 years old. Three cases of these shows optic neuritis combined with transverse myelitis (Devic syndrome), whereas one case revealed the only transverse myelitis. The leukocyte and protein content of CSF was elevated in three cases except one case unchecked. Antiphospholid antibody was not detected in all case. Their images showed cervical or thoracic cord involvement in all cases. In 2 cases, the brainstem involvement was combined with spinal cord lesion. The serologic disease activity of SLE was correlated with the neurological severity. Results : All patients were young female. Optic neuritis, brainstem involvement, and CSF pleocytosis was frequent relatively compared with conventional transverse myelitis. Only one person was diagnosed as SLE previously, but the others showed purely neurological manifestation initially and then was diagnosed as SLE with laboatroy study. Conclusion : We recommend the consideration for SLE in the patient with optic neuritis, myelitis, or these combinations.