Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 31;32(1):31-38.
doi: 10.31138/mjr.32.1.31. eCollection 2021 Mar.

Spectrum of Myelitis in Systemic Lupus Erythematosus: Experience from a Single Tertiary Care Centre over 25 Years

Pankti Mehta  1 , Latika Gupta  1 , Hafis Muhammed  1 , Durga P Misra  1 , Able Lawrence  1 , Vikas Agarwal  1 , Amita Aggarwal  1 , Ramnath Misra  1
Affiliations

Spectrum of Myelitis in Systemic Lupus Erythematosus: Experience from a Single Tertiary Care Centre over 25 Years

Pankti Mehta et al. Mediterr J Rheumatol. .

Abstract

Background: Inflammatory myelitis rarely occurs in Systemic Lupus Erythematosus (SLE).

Methods: Medical records from a tertiary care centre in India (1989-2018) were reviewed to identify patients with myelitis in SLE and their clinical characteristics and outcomes were compared with two matching comparators drawn from adjacent hospital registration numbers in the SLE database.

Results: Ten patients had myelitis from a cohort of 1768 patients with SLE. Myelitis was the first manifestation of lupus in 7 (70%). Cervicothoracic cord was most frequent site of involvement. ANA was negative at onset in 2 cases. One of 4 was positive for Anti-Aquaporin 4 antibody. Four had relapsing disease (16 events) with a median time to relapse of 0.65 years (0.3- 7 years). All cases received steroid sparing agents over the follow-up duration (78.5 patient years). Lupus nephritis (20% vs. 75%, p=0.004) and haematologic manifestations (0 vs. 25%, p=0.02) were less common. Higher frequency of anti-Ro antibodies was noted in the group with myelitis (p=0.05).

Conclusion: Myelitis can be a presenting feature of SLE with lupus nephritis and hematologic involvement being rare. Relapses are common that mandate long-term immunosuppression.

Keywords: SLE; demyelinating syndromes; lupus; myelitis; neuromyelitis optica spectrum disorders; neuropsychiatric lupus; rituximab.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Methodology. *SLICC criteria; #by 2015 International Consensus Diagnostic Criteria for NMOSD; LM: Longitudinal myelitis; NMOSD: Neuromyelitis Optica Spectrum Disorder; NPSLE: Neuro-Psychiatric Systemic Lupus Erythematosus; SM: Short Segment Myelitis; SLICC: Systemic Lupus International Collaborating Clinic criteria; SLE: Systemic Lupus Erythematosus
Figure 2.
Figure 2.
Clinical course of the patients. We have classified the patients with myelitis based on the symptom complex at presentation and depicted their clinical course over their follow up period.
See this image and copyright information in PMC

References

    1. Liang MH, Corzillius M, Bae SC, Lew RA, Fortin PR, Gordon C, et al. The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum (Hoboken, NJ) 1999. April 1;42(4):599–608. - PubMed
    1. Bertsias G, Cervera R, Boumpas DT. Systemic Lupus 20 Erythematosus: Pathogenesis and Clinical Features. Systemic Lupus Erythematosus. EULAR Textbook on Rheumatic Diseases, 5, 2012;476–505.
    1. Piga M, Chessa E, Peltz MT, Floris A, Mathieu A, Cauli A. Demyelinating syndrome in SLE encompasses different subtypes: Do we need new classification criteria? Pooled results from systematic literature review and monocentric cohort analysis. Autoimmun Rev 2017. March;16(3):244–52. - PubMed
    1. Birnbaum J, Petri M, Thompson R, Izbudak I, Kerr D. Distinct sub-types of myelitis in systemic lupus erythematosus. Arthritis Rheum 2009. November;60(11):3378–87. - PubMed
    1. Wingerchuk DM, Lennon VA, Lucchinetti CF, Pittock SJ, Weinshenker BG. The spectrum of neuromyelitis optica. Lancet Neurol 2007. September;6(9):805–15. - PubMed

LinkOut - more resources