Abstract：
OBJECTIVE: Acute transverse myelitis (TM) is a rare complication secondary to systemic lupus erythematosus (SLE) that can cause patients\' extensive and severe neuropsychiatric disorders. Due to the rarity of the onset of acute TM, there is still no standard treatment protocol. This study was to summarize the clinical features of SLE-TM through a case report and systematic review.
METHODS: We report a case of acute TM with the initial symptoms of headache and fever on admission to hospital, with lesions in medulla oblongata, cervical medulla, and thoracic medulla. Furthermore, all cases of SLE combined with acute TM from January 1975 to February 2022 were concluded and reviewed to compare the disease\'s current treatment strategies and prognosis.
RESULTS: Patients with SLE-TM are mainly female (97.65%), with an average age of 36.89, a TM incidence of 24.51% and a longitudinal myelitis (LM) incidence of 67.76%. In addition, 68.63% of patients present an increased albumin, and only 16.50% of patients could recover. 32.35% of patients showed positive anti-cardiolipin antibody. Moreover, the patients who could recover are generally younger than those in the improved and paraparesis groups. After classifying the statistical results twice according to magnetic resonance imaging results and prognosis respectively, the erythrocyte sedimentation rate (ESR) in LM group was significantly higher than that in the other two groups. The positive rate of anti-DNA and anti-cardiolipin antibody (ANCL) in TM group was significantly higher than that of the other groups. According to the prognostic grouping, ESR in the recovery group was significantly higher than those in the other two groups. The positive ANCL in the poor prognosis group was slightly higher than that in the other two groups.
CONCLUSIONS: We offer a novel insight for this rare disease and hope to bring some inspiration the basic research for SLE-TM.
METHODS: We report a case of acute TM with the initial symptoms of headache and fever on admission to hospital, with lesions in medulla oblongata, cervical medulla, and thoracic medulla. Furthermore, all cases of SLE combined with acute TM from January 1975 to February 2022 were concluded and reviewed to compare the disease\'s current treatment strategies and prognosis.
RESULTS: Patients with SLE-TM are mainly female (97.65%), with an average age of 36.89, a TM incidence of 24.51% and a longitudinal myelitis (LM) incidence of 67.76%. In addition, 68.63% of patients present an increased albumin, and only 16.50% of patients could recover. 32.35% of patients showed positive anti-cardiolipin antibody. Moreover, the patients who could recover are generally younger than those in the improved and paraparesis groups. After classifying the statistical results twice according to magnetic resonance imaging results and prognosis respectively, the erythrocyte sedimentation rate (ESR) in LM group was significantly higher than that in the other two groups. The positive rate of anti-DNA and anti-cardiolipin antibody (ANCL) in TM group was significantly higher than that of the other groups. According to the prognostic grouping, ESR in the recovery group was significantly higher than those in the other two groups. The positive ANCL in the poor prognosis group was slightly higher than that in the other two groups.
CONCLUSIONS: We offer a novel insight for this rare disease and hope to bring some inspiration the basic research for SLE-TM.
摘要：
目的：急性横贯性脊髓炎（TM）是继发于系统性红斑狼疮（SLE）的罕见并发症，可引起患者广泛和严重的神经精神疾病。由于急性TM的罕见发作，目前尚无标准治疗方案.本研究通过1例SLE-TM病例报告及系统评价,总结SLE-TM的临床特点。
方法：我们报告一例急性TM，入院时出现头痛和发热的首发症状，延髓有病变，颈髓质,和胸髓.此外，对1975年1月至2022年2月所有SLE合并急性TM的病例进行总结和回顾,以比较该疾病目前的治疗策略和预后.
结果：SLE-TM患者主要为女性（97.65%），平均年龄36.89岁，TM发病率24.51%，纵向脊髓炎(LM)发病率67.76%。此外,68.63%的患者出现白蛋白增加，只有16.50%的患者能够康复。32.35%的患者抗心磷脂抗体阳性。此外，可以康复的患者通常比改善和轻瘫组的患者年轻。在根据磁共振成像结果和预后分别对统计结果进行两次分类后，LM组的红细胞沉降率（ESR）明显高于其他两组。TM组的抗DNA和抗心磷脂抗体（ANCL）阳性率明显高于其他组。根据预后分组，恢复组ESR明显高于其他两组。预后不良组的ANCL阳性略高于其他两组。
结论：我们为这种罕见疾病提供了新的见解，并希望为SLE-TM的基础研究带来一些启发。
方法：我们报告一例急性TM，入院时出现头痛和发热的首发症状，延髓有病变，颈髓质,和胸髓.此外，对1975年1月至2022年2月所有SLE合并急性TM的病例进行总结和回顾,以比较该疾病目前的治疗策略和预后.
结果：SLE-TM患者主要为女性（97.65%），平均年龄36.89岁，TM发病率24.51%，纵向脊髓炎(LM)发病率67.76%。此外,68.63%的患者出现白蛋白增加，只有16.50%的患者能够康复。32.35%的患者抗心磷脂抗体阳性。此外，可以康复的患者通常比改善和轻瘫组的患者年轻。在根据磁共振成像结果和预后分别对统计结果进行两次分类后，LM组的红细胞沉降率（ESR）明显高于其他两组。TM组的抗DNA和抗心磷脂抗体（ANCL）阳性率明显高于其他组。根据预后分组，恢复组ESR明显高于其他两组。预后不良组的ANCL阳性略高于其他两组。
结论：我们为这种罕见疾病提供了新的见解，并希望为SLE-TM的基础研究带来一些启发。
