Transverse myelitis as a first manifestation of systemic lupus
erythematosus (SLE) is very uncommon. No pathognomonic
clinical or biochemical characteristics exist, and therefore an early
diagnosis is often difficult. Therapy with intravenous pulses of
methylprednisolone and cyclophosphamide has been shown to improve the
prognosis. However, morbidity and mortality rates
in transverse myelitis are still high due to the fact that complications
such as opportunistic infections and pulmonary
embolism are still frequent causes of death. We report a woman with
relapsing transverse myelitis which was the first
manifestation of SLE. A good response to pulse methylprednisolone and
cyclophosphamide therapy was obtained but she died
later as a result of a pulmonary embolism. We conclude that intravenous
pulse methylprednisolone and cyclophosphamide
therapy improve the prognosis of transverse myelitis associated with SLE
but that a careful follow-up is needed to avoid
complications due to the illness itself or secondary to the therapy.
Lopez Dupla M Khamashta MA Sanchez
AD Ingles FP Uriol PL Aguado AG
Department of Internal Medicine,
Santa Tecla Hospital, Tarragona,
Spain.
"Hello all and hows Rod Preston? Like the silance? You can thank my ISP
{The Diamond Lane} and Chris the operator for the fix. If we don't get
an apology I'll post the persons responsible email and phone #. But back
to TM. I contacted the Lupus thread and looked all the posts and found
all the responces [2] to Ms Creed to have never heard of a connection,
between Lupus and TM. Now I'm looking through Medline. I found the above
and
this".
DATE: 1995 Sep-Oct
Abstract
We report the clinical case of an 8 years female with systemic lupus
erythematosous who developed transverse myelitis
secondary to antiphospholipid syndrome. She had an excellent response to
the treatment with Prednisone and
Cyclophosphamide. As long as we know this is the first report of
transverse myelitis as clinical manifestation of
antiphospholipid syndrome in childhood.
Espinosa-Rosales F Berr*n-P*rez R
Onuma-Takane E Ortega-Martell JA
Servicio de Inmunolog*a, Instituto
Nacional de Pediatr*a, M*xico D.F., M*xico.
Transliterated/vernacular title: Mielitis transversa como
manifestaci*n inicial del s*ndrome antifosfol*pido secundario.
Informe de un caso.
English Indicator: A
1995 960822 "And
this"
DATE: 1993 Jun
Abstract
Transverse myelitis has been cited as a rare and unusual complication of
systemic lupus erythematosus (SLE). A review of
the literature reveals only 10 cases of transverse myelitis as the
initial presentation of SLE, and only one with reported
benefits from antimalarial therapy. The case of a 30-year-old woman is
reviewed. She presented to the emergency room with
complaints of hypogastric and low back pain. The ensuing course was one
of frank urinary retention and rapidly progressing
quadriparesis. Magnetic resonance imaging of the spine revealed marked
edema of the cervical and thoracic spine. A diagnosis
of SLE was based on positive antinuclear antibodies and leukopenia. The
patient was treated with high dose
methylprednisolone, plasmapheresis and pulse cyclophosphamide for 3
months. Subsequently, treatment was begun with
hydroxychloroquine, and significant improvement in her neurologic and
functional status was achieved after 1 month of therapy.
Ten months after her onset of symptoms, the patient suffered an acute
exacerbation of paraparesis and urinary retention.
Again, she improved clinically after high dose methylprednisolone and
pulse cyclophosphamide for 1 month.
Hydroxychloroquine was continued throughout the duration of therapy.
Klaiman MD Miller SD
Number of references: 21
Department of Rehabilitation Medicine, Columbia University,
Presbyterian Hospital, City of New York, New York.
1993 960823
Medlars UID
93290823
"I'm I afraid I'll get Lupus NO, should you NO, does her client have
Lupus because of TM? No way to prove it. So back to the question "What
causes TM???" Bryan Kessler said it best, that any number of illnesses
can accompany TM but it doesn't prove a thing. Sorry! God bless you
all". //DCJones {Dave}