Recurrence of Transverse Myelitis After Long Term Neurological Recovery Associated with Antiphospholipid Antibodies in a Patient with Systemic Lupus Erythematosus : A Case Report

全身性紅斑性狼瘡伴有抗磷脂抗體及橫斷性脊髓炎經長期神經恢復後再發：病例報告

王顏和(Yen-Ho Wang) ； 蔡偉(Woei Tsay) ； 殷光達(Guang-Dar Yin) ； 黃國茂(Kou-Mou Huang) ； 黃天祥(Tien-Shang Huang)

《中華民國復健醫學會雜誌》 27卷4期 (1999/12) Pp. 227-234

摘要

一位44歲台灣女性在1984年發生T5橫斷性脊髓炎，八年後診斷出患有全身性紅斑性狼瘡。其病況對投予的藥物prednisolone及azathioprine反應良好，並獲得神經完全恢復。1997年8月，在鄰近的T6到T8胸髓段又發生病變，高濃度抗磷脂抗體與多項血清狼瘡活性檢查顯示與該次橫斷性脊髓炎復發有關， methylprednisolone脈衝式治療再次對其病情之療效良好，其神經功能幾乎完全恢復，復發四個月後的核磁共振檢查顯示脊髓有明顯改善。由於全身性紅斑性狼瘡併發橫斷性脊髓炎在神經功能完全恢復後十三年再發極為罕見，因此提出報告，同時檢測其抗磷脂抗體之變化。

關鍵字

橫斷性脊髓炎 ； 全身性紅斑性狼瘡 ； 脈衝式治療 ； 抗磷脂抗體

並列摘要

A 44-year-old female Taiwanese developed T5 transverse myelitis (TM) in 1984, eight years before the diagnosis of systemic lupus erythematosus (SLE). She responded very well to prednisolone and azathioprine administration and had complete neurological recovery. In August 1997, a relapse of TM at vicinal level, T6, occurred. Magnetic resonance image of the spinal cord revealed long segment involvement from T4 to T8. High titer of antiphospholipid antibodies and various serological markers of lupus activity were found to correlate with this relapse of TM. She responded very well to methylprednisolone pulse therapy with nearly complete neurological recovery. Follow-up examination of magnetic resonance imaging, 4 months after relapse, revealed much improvement. Here we report this rare condition in a woman with SLE, who suffered relapse of TM 13 years after a previous episode with complete neurological recovery. A sequential change of antiphospholipid antibodies correlated with LE activities was also presented.

並列關鍵字

transverse myelitis ； SLE ； pulse therapy ； antiphospholipid antibodies