This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Bonnet, F Articles by Leng, B Search for Related Content PubMed PubMed Citation Articles by Bonnet, F Articles by Leng, B Social Bookmarking                         What's this?

Devic's neuromyelitis optica during pregnancy in a patient with systemic lupus erythematosus

Services de médecine interne et maladies infectieuses, Hôpital Haut Lévêque et Hôpital Saint-André

P Mercié

Services de médecine interne et maladies infectieuses, Hôpital Haut Lévêque et Hôpital Saint-André; Clinique de médecine interne et maladies infectieuses, Centre François Magendie, Hôpital Haut Lévêque, Centre Hospitalier Universitaire de Bordeaux, 33604 Pessac, France

P Morlat

Services de médecine interne et maladies infectieuses, Hôpital Haut Lévêque et Hôpital Saint-André

C Hocke

Service de gynécologie-obstétrique, Hôpital Saint-André

C Vergnes

Laboratoire d'hématologie, Hôpital Haut Lévêque, Centre Hospitalier Universitaire de Bordeaux, 33075 Bordeaux, France

E Ellie

Services de médecine interne et maladies infectieuses, Hôpital Haut Lévêque et Hôpital Saint-André

J-F Viallard

I Faure

J-L Pellegrin

J Beylot

B Leng

Services de médecine interne et maladies infectieuses, Hôpital Haut Lévêque et Hôpital Saint-André

Neuropsychiatric forms of systemic lupus erythematosus (SLE) vary, most commonly consisting of seizures, psychiatric disturbances, or focal central nervous deficits. This is a new case of neuromyelitis optica or Devic's syndrome during the course of SLE. Few reports of this association exist in the literature. Our objective is to report this unique case of Devic's neuromyelitis optica during pregnancy in a patient with systemic lupus erythematosus. A 28-year-old woman had been diagnosed as having SLE with cutaneous and articular involvement in 1987 when she was 17 years old. She was treated with a synthetic antimalarial agent associated with corticosteroids. In 1994, during the fourth month of pregnancy, she had signs of transverse myelitis with a sensory level at T6 associated with an optic neuropathy suggesting a Devic's syndrome. The patient was managed by plasmapheresis sessions and intravenous corticosteroids. Transverse myelitis recurred postpartum and three years later at the same thoracic level. Management by bolus administration of a steroid and cyclophosphamide resulted in remission again. There have only been around a dozen reports in the literature of patients who had both Devic's neuromyelitis optica and SLE. Magnetic resonance imaging is contributive to diagnosis and therapeutic follow-up, showing spinal cord lesions with increased intensity on T2-weighted sequences. Although the clinical course of the present patient has been favourable so far, the prognosis of this neurologic disease is generally considered to be poor with elevated mortality.

Key Words: systemic lupus erythematosus • neuromyelitis optica

Lupus, Vol. 8, No. 3, 244-247 (1999)
DOI: 10.1191/096120399678847696


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M Bonnan, R Valentino, S Olindo, H Mehdaoui, D Smadja, and P Cabre Plasma exchange in severe spinal attacks associated with neuromyelitis optica spectrum disorder Multiple Sclerosis, April 1, 2009; 15(4): 487 - 492. [Abstract] [PDF]

				R Hewett and R Coleman A devilishly interesting case Practical Neurology, June 1, 2008; 8(3): 186 - 190. [Full Text] [PDF]

				C Jacobi, K Stingele, R Kretz, M Hartmann, B Storch-Hagenlocher, A Breitbart, and B Wildemann Neuromyelitis optica (Devic's syndrome) as first manifestation of systemic lupus erythematosus Lupus, February 1, 2006; 15(2): 107 - 109. [Abstract] [PDF]

				J Sastre-Garriga and X Montalban APS and the brain Lupus, December 1, 2003; 12(12): 877 - 882. [Abstract] [PDF]

				J de Seze, C Lebrun, T Stojkovic, D Ferriby, M Chatel, and P Vermersch Is Devic's neuromyelitis optica a separate disease? A comparative study with multiple sclerosis Multiple Sclerosis, October 1, 2003; 9(5): 521 - 525. [Abstract] [PDF]

				C. F. Lucchinetti, R. N. Mandler, D. McGavern, W. Bruck, G. Gleich, R. M. Ransohoff, C. Trebst, B. Weinshenker, D. Wingerchuk, J. E. Parisi, et al. A role for humoral mechanisms in the pathogenesis of Devic's neuromyelitis optica Brain, July 1, 2002; 125(7): 1450 - 1461. [Abstract] [Full Text] [PDF]

				A. N. Gibbs, J. Moroney, D. Foley-Nolan, and P. G. O'Connell Neuromyelitis optica (Devic's syndrome) in systemic lupus erythematosus: a case report Rheumatology, April 1, 2002; 41(4): 470 - 471. [Full Text] [PDF]

				A Aziz, M D Conway, H J Robertson, L R Espinoza, and W A Wilson Acute optic neuropathy and transverse myelopathy in patients with antiphospholipid antibody syndrome: Favorable outcome after treatment with anticoagulants and glucocorticoids Lupus, May 1, 2000; 9(4): 307 - 310. [Abstract] [PDF]

				D. Giorgi and L. Bonomo Reply Rheumatology, February 1, 2000; 39(2): 216 - 217. [Full Text] [PDF]