scholarly journals Spinal cord compression by epidural lipomatosis in a patient with systemic lupus erythematosus

1992 ◽  
Vol 35 (4) ◽  
pp. 482-484 ◽  
Author(s):  
Hulon E. Crayton ◽  
Curtis R. Partington ◽  
Carolyn L. Bell
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Lupus Erythematosus ◽  
Cord Compression ◽  
Systemic Lupus ◽  
Epidural Lipomatosis

scholarly journals Spinal cord syndromes in patients with systemic lupus erythematosus: differentiating lupus myelitis, neuromyelitis optica, and multiple sclerosis

Lupus ◽  
2019 ◽  
Vol 28 (14) ◽  
pp. 1656-1662
Author(s):  
J N Williams ◽  
C B Speyer ◽  
D J Kreps ◽  
D J Kimbrough ◽  
K Costenbader ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systemic Lupus Erythematosus ◽  
Spinal Cord ◽  
Disease Activity ◽  
Neuromyelitis Optica ◽  
Lupus Erythematosus ◽  
Clinical Laboratory ◽  
Activity Index ◽  
Disease Activity Index ◽  
Systemic Lupus

Objective Non-infectious myelitis in systemic lupus erythematosus (SLE) may be due to SLE myelitis, comorbid multiple sclerosis (MS), or neuromyelitis optica (NMO). We compared characteristics of these three conditions in SLE patients at a large academic institution. Methods We searched for neurologic diagnoses of SLE myelitis, NMO myelitis, and MS myelitis among 2297 patients with at least four 1997 American College of Rheumatology revised criteria for SLE between 2000 and 2015. Each subject was reviewed by a neurologist to confirm the underlying neurologic diagnosis. Demographic, clinical, laboratory, and radiographic data were extracted and compared using Fisher's exact test, analysis of variance, and Wilcoxon rank-sum test. Results Fifteen of the 2297 subjects with SLE (0.7%) met criteria for a spinal cord syndrome: seven had SLE myelitis, three had AQP4 seropositive NMO, and five had MS. The median SLE Disease Activity Index 2000 score at time of neurologic syndrome presentation was higher in SLE myelitis subjects (8, interquartile range (IQR) 7–16) compared with subjects with NMO (6, IQR 0–14) or MS (2, IQR 0–4), p = 0.02. Subjects with SLE myelitis were also more likely to have elevated anti-dsDNA antibodies at presentation (86%) compared with subjects with NMO (33%) or MS (0%), p = 0.03. Conclusion Myelitis occurs rarely among patients with SLE. Compared with subjects with SLE + NMO and subjects with SLE + MS, subjects with SLE myelitis had higher SLE disease activity at presentation.

scholarly journals Systemic lupus erythematosus flare up as acute spinal subarachnoid hemorrhage with bilateral lower limb paralysis

2018 ◽  
Author(s):  
Xiang Yang ◽  
Seidu A. Richard ◽  
Jiagang Liu ◽  
Siqing Huang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Subarachnoid Hemorrhage ◽  
Lupus Erythematosus ◽  
Neurological Complications ◽  
Cord Compression ◽  
Normal Function ◽  
Lower Limbs ◽  
Systemic Lupus ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal

Subarachnoid hemorrhage (SAH) is an uncommon complication of systemic lupus erythematosus (SLE). Solitary association of fatal spinal SAH as a complication of SLE, has not been encountered much in literature although coexisting acute cerebral and spinal SAH have been associated with SLE. We present a 39-year old female with initial diagnosis of SLE eight years ago who suddenly developed a productive cough, acute abdomen and paralysis of the lower limbs. Magnetic resonance imaging of the spine revealed thoracic spinal SAH with varying degrees of thoracic spinal cord compression. The hemorrhage was total evacuated via surgery. She regained normal function of her lower limbers after the operation with no further neurological complications. One of the rare but fatal complications of SLE is solitary spinal SAH without cranial involvement. The best and most appropriate management of this kind of presentation is surgical decompression of the hematoma with total hemostasis. The cause of hemorrhage should be identified intra-operatively and treated appropriately.

scholarly journals Lupus myelopathy

2017 ◽  
Vol 18 (1) ◽  
pp. 66-69
Author(s):  
Dominika D Raciborska ◽  
Alastair John Noyce ◽  
Dev Pyne ◽  
Benjamin P Turner
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Spinal Cord ◽  
Lupus Erythematosus ◽  
Multidisciplinary Approach ◽  
Neurological Manifestations ◽  
Serological Evidence ◽  
Systemic Lupus ◽  
Central Nervous System Lupus ◽  
Specific Symptoms ◽  
Repeat Imaging

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.

scholarly journals Acute spinal cord compression due to epidural lipomatosis complicated by an abscess: magnetic resonance and pathology findings

2010 ◽  
Vol 19 (S2) ◽  
pp. 216-219 ◽  
Author(s):  
Giulio Zuccoli ◽  
Nicolò Pipitone ◽  
Nicola De Carli ◽  
Luigi Vecchia ◽  
Stefano C. Bartoletti
Keyword(s):  
Spinal Cord ◽  
Magnetic Resonance ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Epidural Lipomatosis

Symptomatic epidural lipomatosis secondary to obesity

1996 ◽  
Vol 85 (2) ◽  
pp. 348-350 ◽  
Author(s):  
Krishna Kumar ◽  
Rahul K. Nath ◽  
C. P. V. Nair ◽  
S. P. Tchang
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Weight Ratio ◽  
Cord Compression ◽  
Thoracic Spinal Cord ◽  
Content Type ◽  
Epidural Lipomatosis ◽  
Epidural Fat ◽  
Fat Thickness ◽  
Fine Print

✓ The authors present a case of thoracic spinal cord compression secondary to epidural lipomatosis in an obese patient. This patient represents the 10th case of epidural lipomatosis secondary to simple obesity reported in the literature. The diagnosis is based on three criteria: 1) medical history and physical examination consistent with segmental spinal cord compression; 2) epidural fat thickness greater than 7 mm in the region of compression, based on magnetic resonance imaging (preferred) or computerized tomographic imaging; and 3) a height-to-weight ratio greater than 27.5 kg/m2. This specific correlation between epidural fat thickness measurement and calculation of height-to-weight ratio has not previously been reported. Surgical decompression through a posterior laminectomy and excision of excess epidural fat resulted in immediate reversal of the patient's symptoms. Knowledge of the association of epidural lipomatomis with obesity in the absence of glucocorticoid imbalance is important in discerning what may be an underrecognized syndrome.

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