Understanding the Antibody Repertoire in Neuropsychiatric Systemic Lupus Erythematosus and Neuromyelitis Optica Spectrum Disorder

2018 ◽  
Vol 70 (2) ◽  
pp. 277-286 ◽  
Author(s):  
Simone Mader ◽  
Venkatesh Jeganathan ◽  
Yoshiyuki Arinuma ◽  
Yuichiro Fujieda ◽  
Irena Dujmovic ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Neuromyelitis Optica ◽  
Lupus Erythematosus ◽  
Spectrum Disorder ◽  
Antibody Repertoire ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Systemic Lupus ◽  
Neuropsychiatric Systemic Lupus Erythematosus

Neuromyelitis optica spectrum disorder and systemic lupus erythematosus

Lupus ◽  
2019 ◽  
Vol 28 (14) ◽  
pp. 1722-1726 ◽  
Author(s):  
M M Thabah ◽  
Sekar D ◽  
R Pranov ◽  
M M V Moulitej ◽  
A Ramesh ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Neuromyelitis Optica ◽  
Lupus Erythematosus ◽  
Transverse Myelitis ◽  
Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Systemic Lupus ◽  
Autoimmune Conditions ◽  
Inflammatory Syndrome ◽  
Extensive Transverse Myelitis

Neuromyelitis optica spectrum disorder is an inflammatory syndrome that is associated with many autoimmune conditions. We present the case of a patient who had longitudinally extensive transverse myelitis and antibodies to aquaporin 4 IgG (AQP4-IgG). Based on presence of lymphopenia, further workup revealed strong ANA positivity, anti-Sm antibodies, and low serum complements suggesting presence of systemic lupus erythematosus. The patient promptly responded to intravenous pulse methylprednisolone and five sessions of plasma exchange. At 1 year, she is on maintenance treatment with low dose prednisolone, azathioprine, and hydroxychloroquine, she has had no relapse and no other clinical features of lupus. This case is an illustration that neuromyelitis optica spectrum disorder can be the first manifestation of systemic lupus erythematosus.

Refractory neuromyelitis optica spectrum disorder in systemic lupus erythematosus successfully treated with rituximab

Lupus ◽  
2018 ◽  
Vol 27 (8) ◽  
pp. 1374-1377 ◽  
Author(s):  
K Shidahara ◽  
K Hayashi ◽  
K E Sada ◽  
S Hiramatsu ◽  
M Morishita ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Neuromyelitis Optica ◽  
Lupus Erythematosus ◽  
Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Systemic Lupus ◽  
Spinal Lesions ◽  
Aqp4 Antibody ◽  
Established Treatment ◽  
Optic Nerve Involvement

We present a case of a woman with systemic lupus erythematosus (SLE) who had refractory episodes of neuromyelitis optica spectrum disorder (NMOSD) and was successfully treated with rituximab. She was positive for anti-aquaporin-4 (AQP4) antibody and had typical cranial and longitudinally extended spinal lesions but no optic nerve involvement. There is no established treatment for NMOSD/SLE overlap cases. Our experience suggests that rituximab may be effective for patients with combined SLE and anti-AQP4 antibody-positive NMOSD.

Disseminated nocardiosis in an immunosuppressed patient with systemic lupus erythematosus and neuromyelitis optica spectrum disorder

Lupus ◽  
2020 ◽  
pp. 096120332097692 ◽  
Author(s):  
Sima Terebelo ◽  
Sara Sharif ◽  
Zeshan A Chaudhry ◽  
Ellen Ginzler
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Autoimmune Disease ◽  
Neuromyelitis Optica ◽  
Lupus Erythematosus ◽  
Immunosuppressive Agents ◽  
Spectrum Disorder ◽  
Immunosuppressed Patient ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Systemic Lupus ◽  
Disseminated Nocardiosis

Opportunistic infections are an ongoing concern in patients with autoimmune disease who are being treated with immunosuppressive agents. Nocardiosis is an uncommon opportunistic infection which has been reported in association with immunosuppressed patients and autoimmune disease. It is challenging to diagnose and can have multisystem manifestations. Failure to diagnose and appropriately treat can result in significant mortality. We present a 49 year old woman with systemic lupus erythematosus and neuromyelitis optica spectrum disorder who was treated with mycophenolate mofetil, prednisone and recent plasmapheresis. She developed acute onset of shortness of breath and fevers and was ultimately diagnosed with disseminated nocardiosis with lung, brain and muscle abscesses.

scholarly journals Neuromyelitis optica spectrum disorder in patient with systemic lupus erythematosus - our experience

2018 ◽  
Vol 75 (1) ◽  
pp. 104-107
Author(s):  
Ksenija Bozic ◽  
Nenad Komatina ◽  
Milan Petronijevic ◽  
Bojana Knezevic ◽  
Dejan Kostic ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Neuromyelitis Optica ◽  
Lupus Erythematosus ◽  
Transverse Myelitis ◽  
Spectrum Disorder ◽  
Patient Treatment ◽  
Caucasian Woman ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Systemic Lupus ◽  
Longitudinal Extensive Transverse Myelitis

Introduction. Neuromyelitis optica spectrum disorder (NMOSD) is a rare demyelinating immune-mediated central nervous system disease. It is extremely rare to occur in patients with systemic lupus erythematosus (SLE), and it represents a diagnostic and therapeutic challenge. Case report. A 38-year-old Caucasian woman with medical history of SLE and new onset of flaccid paraparesis, fecal and urinary incontinence, persistent nausea and vomiting was admitted to our hospital. Based on the clinical presentation, magnetic resonance imaging findings and positive aquaporin 4 (AQP4) antibodies, a NMOSD with coexisting SLE were diagnosed. Pulse-doses of cyclophosphamide and glucocorticoids were efficient in patient treatment. Conclusion. In a patient with SLE and symptoms of longitudinal extensive transverse myelitis and/or optic neuritis and area postrema syndrome, assessment of AQP4 antibodies is neccessary for diagnosing NMOSD. Accurate diagnosis, and timely and long-term administration of immunosuppressive therapy are crucial for favorable outcome of these two coexisting diseases.

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