Tavor Yonit, Herskovitz Moshe, Ronen Galia, Balbir-Gurman Alexandra
B. Shine Rheumatology Unit, Rambam Health Care Campus, Haifa, Israel.
The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Rambam Maimonides Med J. 2021 Jan 19;12(1):e0006. doi: 10.5041/RMMJ.10429.
Transverse myelitis is an inflammatory lesion of the spinal cord, occurring in different autoimmune, infectious, and traumatic diseases but is the hallmark of neuromyelitis optica (NMO), a rare neurologic autoimmune disease. Patients with systemic lupus erythematosus (SLE) may develop transverse myelitis as a neuropsychiatric complication of active disease; however, at times, NMO co-exists as an additional primary autoimmune condition in a SLE patient. Correct diagnosis of a SLE-NMO overlap is important not only for the different disease course and prognosis compared with SLE-related LETM, but especially for the emerging and highly specific NMO treatment options, not established for SLE-related LETM-such as anti-aquaporin 4 antibodies, anti-VEGF antibodies, complement modulation, or IVIg.
横贯性脊髓炎是脊髓的一种炎性病变，可发生于多种自身免疫性、感染性和创伤性疾病中，但它是视神经脊髓炎（NMO）的标志性特征，NMO是一种罕见的神经自身免疫性疾病。系统性红斑狼疮（SLE）患者可能会出现横贯性脊髓炎，作为活动性疾病的神经精神并发症；然而，有时NMO会作为SLE患者额外的原发性自身免疫性疾病共存。正确诊断SLE-NMO重叠不仅对于与SLE相关的纵向脊髓炎（LETM）相比不同的病程和预后很重要，而且对于新兴的、高度特异性的NMO治疗方案尤其重要，这些方案尚未应用于SLE相关的LETM，如抗水通道蛋白4抗体、抗血管内皮生长因子抗体、补体调节或静脉注射免疫球蛋白。
