Seminars in Arthritis and Rheumatism
Volume 40, Issue 4 , Pages 349-357 , February 2011

Clinical, Radiologic, and Therapeutic Analysis of 14 Patients with Transverse Myelitis Associated with Antiphospholipid Syndrome: Report of 4 Cases and Review of the Literature

  • Carlos Ewerton Maia Rodrigues, MD

      Affiliations

    • Research Fellow, Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo and College of Medicine of Universidade de São Paulo, São Paulo, SP, Brazil
    • ,
  • Jozélio Freire de Carvalho, MD, PhD

      Affiliations

    • Assistant Professor, Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo and College of Medicine of Universidade de São Paulo, São Paulo, SP, Brazil
    • Corresponding Author InformationAddress reprint requests to: Jozélio Freire de Carvalho, MD, PhD, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455-3o andar-Reumatologia, sala 3190, São Paulo, SP, 01246-903 Brazil

References 

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  3. Cervera R, Piette JC, Font J, Khamashta MA, Shoenfeld Y, Camps MT, et al. Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1000 patients. Arthritis Rheum. 2002;46:1019–1027
  4. Kim JH, Lee SI, Park SI, Yoo WH. Recurrent transverse myelitis in primary antiphospholipid syndromedcase report and literature review. Rheumatol Int. 2004;24:244–246
  5. Sherer Y, Hassin S, Shoenfeld Y, Levy Y, Livneh A, Ohry A, et al. Transverse myelitis in patients with antiphospholipid antibodies—the importance of early diagnosis and treatment. Clin Rheumatol. 2002;21:207–210
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  10. Schantz V, Oestergaard LL, Junker P. Shrinking spinal cord following transverse myelopathy in a patient with systemic lupus erythematosus and the phospholipid antibody syndrome. J Rheumatol. 1998;25:1425–1428
  11. Matsushita T, Kanda F, Yamada H, Chihara K. Recurrent acute transverse myelopathy: an 83-year-old man with antiphospholipid syndrome. Rinsho Shinkeigaku. 1997;37:987–991
  12. Ruiz-Argüelles GJ, Guzmán-Ramos J, Flores-Flores J, Garay-Martínez J. Refractory hiccough heralding transverse myelitis in the primary antiphospholipid syndrome. Lupus. 1998;7:49–50
  13. Takamura Y, Morimoto S, Tanooka A, Yoshikawa J. Transverse myelitis in a patient with primary antiphospholipid syndrome—a case report. No To Shinkei. 1996;48:851–855
  14. Espinosa G, Mendizabal A, Minguez S, Ramo-Tello , Capellades J, Olivé A, et al. Transverse Myelitis affecting more than 4 spinal segments associated with systemic lúpus erytematosus: clinical, immunological, and radiological characteristics of 22 patients. Semin Arthritis Rheum. 2010;39:246-26
  15. Lackner JK, Peetz D, Landenberg P. Revision of the Sapporo criteria for the antiphospholipid syndrome—coming to grips with evidence and Thomas Bayes?. Thromb Haemost. 2006;95:917–919
  16. Transverse myelitis Consortium Working Group. Proposed diagnostic criteria and nosology of acute transverse myelitis. Neurology. 2002;59:499–505
  17. Kovacs B, Lafferty TL, Brent LH, DeHoratius RJ. Tranverse myelopathy in systemic lupus erythematosus: an analysis of 14 cases and review of the literature. Ann Rheum Dis. 2000;59:120–124
  18. Bhat A, Naguwa S, Cheema G, Gershwin ME. The epidemiology of transverse myelitis. Autoimmun Rev. 2010;9:395–399
  19. Sanna G, Bertolaccini ML, Cuadrado MJ, Khamashta MA, Hughes GR. Central nervous system involvement in the antiphospholipid (Hughes) syndrome. Rheumatology (Oxford). 2003;42:200–213
  20. D'Cruz DP, Mellor-Pita S, Joven B, Sanna G, Allanson J, Taylor J, et al. Transverse myelitis as the first manifestation of systemic lupus erythematosus or lupus-like disease: good functional outcome and relevance of antiphospholipid antibodies. J Rheumatol. 2004;31:280–285
  21. Mok CC, Lau CS, Chan EY, Wong RW. Acute transverse myelitis in systemic lupus erythematosus: clinical presentation, treatment, and outcome. J Rheumatol. 1998;25:467–473
  22. Lavelle C, Pizarro S, Drenkard C, Sanchez-Guerrero J, Alarcon-Segovia D. Transverse myelitis: a manifestation of systemic lupus erythematosus strongly associated with antiphospholipid antibodies. J Rheumatol. 1990;17:34–37
  23. West SG, Emlen W, Wener MH, Kotzin BL. Neuropsychiatric lupus erythematosus: a 10-year prospective study on the value of diagnostic tests. Am J Med. 1995;99:153–163
  24. Chan KF, Boey ML. Transverse myelopathy in SLE: clinical features and functional outcomes. Lupus. 1996;5:294–299
  25. Berman M, Feldman S, Alter M, Zilber N, Kahana E. Acute transverse myelitis: incidence and etiologic considerations. Neurology. 1981;31:966–971
  26. Altrocchi PH. Acute transverse myelopathy. Arch Neurol. 1963;9:21–29
  27. Misra UK, Kalita J, Kumar S. A clinical MRI and neurophysiological study of acute transverse myelitis. J Neurol Sci. 1996;138:150–156
  28. Jacob A, Weinshenker BG. An approach to the diagnosis of acute transverse myelitis. Semin Neurol. 2008;28:105–120

 Carvalho received grants from the Federico Foundation and CNPq (300665/2009-1).

PII: S0049-0172(10)00077-6

doi: 10.1016/j.semarthrit.2010.05.004

Seminars in Arthritis and Rheumatism
Volume 40, Issue 4 , Pages 349-357 , February 2011

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