Exploring the risk factors and prognosis of transverse myelitis in systemic lupus erythematosus

• Main Authors: Minhui Wang (Author), Ziqian Wang (Author), Li Zhang (Author), Jiuliang Zhao (Author), Di Wu (Author), Jing Li (Author), Qian Wang (Author), Jinmei Su (Author), Dong Xu (Author), Shangzhu Zhang (Author), Mengtao Li (Author), Xiaofeng Zeng (Author)
• Format: Book
• Published: SAGE Publishing, 2022-05-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Purpose: We aimed to describe the clinical characteristics and outcomes of patients with transverse myelitis (TM) as a rare manifestation in systemic lupus erythematosus (SLE) and explore the risk factors and prognosis of SLE-related TM (SLE-TM). Methods: We conducted a retrospective case-control and cohort analysis. All patients with SLE-TM (58 patients) and 232 with SLE without TM, as a control group, were admitted to Peking Union Medical College Hospital between January 1993 and May 2021. Factors associated with the presence of SLE-TM and its prognosis were assessed using logistic regression and Cox proportional hazard models. Results: Multivariate analysis revealed that positive anti-Ro/Sjogren's syndrome A (anti-Ro/ SSA) (<0.01) and increased erythrocyte sedimentation rate (ESR) ( p  < 0.01) were associated with SLE-TM. Regarding prognosis, methylprednisolone (MP) pulse therapy within 2 weeks of onset (adjusted hazard ratio (AHR), 2.12; 95% confidence interval (CI), 1.06-4.23; p  = 0.03) was associated with short-term neurological improvement. An American Spinal Injury Association Impairment Scale (AIS) grades of A, B, or C at onset (AHR, 0.12; 95% CI 0.05-0.28; p  < 0.001) and hypoglycorrhachia (AHR, 0.29; 95% CI, 0.13-0.65; p  < 0.01) were associated with a short-term non-improved outcome. Conclusions: The positive anti-Ro/SSA antibodies and increased ESR may be associated with the presence of SLE-TM. An initial presentation with severe myelitis and hypoglycorrhachia appear to be predictors of a poor neurological outcome. Early steroid pulse therapy may improve the prognosis.

Item Description

2040-6231
10.1177/20406223221097330