Lupus myelopathy. Issue 1 (2nd November 2017)

• Record Type: Journal Article
• Authors: Raciborska, Dominika D; Noyce, Alastair John; Pyne, Dev; Turner, Benjamin P
• Is Part Of: Practical neurology. Volume 18:Issue 1(2018)
• Page Start: 66
• Page End: 69
• Publication Date: 2017-11-02
• Subjects: sle -- myelopathy -- neuroimmunology -- rheumatology -- neuropharmacology; Neurology -- Periodicals; 616.8005
• DOI: 10.1136/practneurol-2017-001756
• Languages: English
• ISSNs: 1474-7758

Abstract

Abstract : Although neurological manifestations of systemic lupus erythematosus (SLE) are well recognised, myelopathy complicating SLE is rare. A 35-year-old woman presented with non-specific symptoms and a respiratory tract infection but had serological evidence of SLE. She subsequently deteriorated rapidly, developing a catastrophic spinal cord syndrome. Her initial MRI was normal; but after 1 month, her encephalopathy having progressed, repeat imaging showed characteristic myelitic changes. She responded only slowly to a combination of cyclophosphamide and corticosteroids. This case exemplifies the mixed presentations of SLE, including the under-recognised 'subpial leukomyelopathy' of central nervous system lupus. It highlights the challenges in managing lupus-related myelopathy and the benefits of a multidisciplinary approach to care.