J Rheum Dis.  2013 Feb;20(1):64-67. 10.4078/jrd.2013.20.1.64.

A Case of Systemic Lupus Erythematosus with Myelitis and Recurrent Neuromyelitis Optica

• Lee JY
• Kim YJ
• Lee JH

• KMID: 2223053
• DOI: http://doi.org/10.4078/jrd.2013.20.1.64

Abstract

Neuromyelitis optica (NMO) is an idiopathic, severe inflammatory demyelinating disease of the central nervous system targeting optic nerves and the spinal cord. It is characterized by acute bilateral visual loss (optic neuritis), acute transverse myelitis, and tends to spare brain early in the disease course. NMO can occur as an isolated condition or secondary to infection, toxin exposure, and autoimmune disease including systemic lupus erythematosus (SLE), sarcoidosis, and Behcet's disease. We experienced a case of SLE with myelitis and recurrent optic neuritis in a 28-year-old woman who presented with recurrent visual disturbance and sudden onset of paraplegia, and report here on this case along with a review of the relevant literature.

Keyword

Systemic lupus erythematosus; Neuromyelitis optica

MeSH Terms

Autoimmune Diseases
Brain
Central Nervous System
Demyelinating Diseases
Female
Humans
Lupus Erythematosus, Systemic
Myelitis
Myelitis, Transverse
Neuromyelitis Optica
Optic Nerve
Optic Neuritis
Paraplegia
Sarcoidosis
Spinal Cord

Figure

• 

  Figure 1. A 28-year-old woman diagnosed with systemic lupus erythematosus, presented with recurrent visual disturbance and sudden onset of paraplegia. (A) Sagittal T2-weighted magnetic resonance image of the cervical spine shows cord enlargement and longitudinal hyperintense lesion extending over 7 vertebral seg-ments. (B) Sagittal fat suppression T2-weighted magnetic resonance image of the cervico-thoracic spine shows a diffuse hyperintense lesion through the cervico-thoracic spine cord from C4 to T10 level.

• 

  Figure 2. Axial T1-weighted contrast enhanced fat suppression image of brain demonstrates subtle enhancement at the right intraorbital nerve (arrow).

Reference

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