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Vol. 13. Num. 6.November - December 2017
Pages 311-370
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Vol. 13. Num. 6.November - December 2017
Pages 311-370
Review Article
DOI: 10.1016/j.reumae.2016.06.005
Myelitis and Lupus: Clinical Manifestations, Diagnosis and Treatment. Review
Mielitis y lupus: clínica, diagnóstico y tratamiento. Revisión
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Edson Hernán Chiganera,
Corresponding author
edsonchiganer@gmail.com

Corresponding author.
, Javier Pablo Hryba,b, Edgar Carnero Contenttib
a Unidad de Inmunología e Histocompatibilidad, Hospital Carlos Durand, Buenos Aires, Argentina
b Servicio de Neurología, Hospital Carlos Durand, Buenos Aires, Argentina
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Table 1. Diagnostic Criteria for Myelitis in Systemic Lupus Erythematosus.
Table 2. Differences Between Myelitis With Gray Matter and With White Matter Involvement in Systemic Lupus Erythematosus.
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Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple systems. Myelopathy is one of 19 neuropsychiatric syndromes related to SLE defined by the American College of Rheumatology. Although infrequent, it is a severe manifestation, leading to motor and sensory deficits, and sphincter dysfunction. The pathogenesis is not clearly known, but may be related to arterial thrombosis and vasculitis. Diagnosis is based on clinical findings, laboratory tests and the use of gadolinium-enhanced magnetic resonance imaging. The standard therapy is the combination of intravenous cyclophosphamide and glucocorticoids. In refractory disease, other treatments such as plasmapheresis or rituximab have been used.

Keywords:
Systemic lupus erythematosus
Lupus myelitis
Neuropsychiatric lupus
Resumen

El lupus eritematoso sistémico (LES)es una enfermedad autoinmune crónica que afecta múltiples sistemas. La mielopatía es uno de los 19 síndromes neuropsiquiátricos relacionados al LES, definidos por el Colegio Estadounidense de Reumatología. Aunque infrecuente, es una manifestación grave que cursa con déficit motor y sensitivo, y disfunción de los esfínteres. La fisiopatogenia no se conoce claramente, pero podría estar relacionada con trombosis arterial y/o vasculitis. El diagnóstico se basa en los hallazgos clínicos, los exámenes de laboratorio y el uso de la resonancia magnética con gadolinio. El tratamiento estándar es la combinación de ciclofosfamida y glucocorticoides por vía intravenosa. En casos refractarios se han utilizado otros tratamientos, como plasmaféresis o rituximab.

Palabras clave:
Lupus eritematoso sistémico
Mielitis lúpica
Lupus neuropsiquiátrico

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