Successful high dose glucocorticoid treatment for subacute neuromyelitis optica with systemic lupus erythematosus.

Abstract

A 54-year-old Japanese woman with a 6-year history of systemic lupus erythematosus (SLE) was admitted to our hospital suffering from acute blindness in her right eye. Her condition recovered after steroid pulse therapy, however, 18 months later she suffered from nuchal pain for 2 weeks after which right hemiparesis with urinary incontinence developed. A spinal magnetic resonance imaging (MRI) revealed cord swelling from C2 to C7. She was diagnosed with neuromyelitis optica (NMO) and intravenous steroid administrations were immediately commenced. Her condition promptly improved. This case was unique because the steroid treatment was quite effective for this case of myelitis, which had passed the acute phase. We supposed that, because most of the lesion was not necrotic or demyelinated, but rather showed edematous change caused by vasculitis based on autoimmune pathogenesis, the symptoms progressed rather gradually and improved promptly in response to glucocorticoid treatment.

• Authors: Noriko Hagiwara, Kazunori Toyoda, Takeshi Uwatoko, Kotaro Yasumori, Setsuro Ibayashi, Yasushi Okada
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 44 Issue 9 Pg. 998-1001 (Sep 2005) ISSN: 0918-2918 [Print] Japan
• PMID: 16258221 (Publication Type: Case Reports, Journal Article)

Chemical References

• Glucocorticoids

Topics

• Acute Disease
• Female
• Glucocorticoids (administration & dosage, therapeutic use)
• Humans
• Lupus Erythematosus, Systemic (complications, drug therapy)
• Magnetic Resonance Imaging
• Middle Aged
• Neuromyelitis Optica (drug therapy, etiology, pathology)
• Spinal Cord (pathology)