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Myelopathy, Ascites and Pleural Effusion in Systemic Lupus Erythematosus
Author(s) -
Waga Shinobu,
Nukii Kiyotaka,
Sugimoto Kazuhiko,
Tanaka Hiroshi,
Furukawa Hidetsugu,
Sashinami Tsukasa
Publication year - 1989
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.1989.tb01273.x
Subject(s) - medicine , ascites , anti nuclear antibody , pleural effusion , methylprednisolone , myelopathy , gastroenterology , prednisolone , rash , effusion , systemic lupus erythematosus , pleurisy , surgery , immunology , antibody , autoantibody , disease , psychiatry , spinal cord
A 12‐year‐old girl with transverse myelopathy, massive pleural effusion and ascites as the presenting features of systemic lupus erythematosus (SLE), is described. All these features developed within a week, but other manifestations of SLE such as malar rash and arthritis were not seen during the illness. Investigations revealed positive direct Coombs' test, high titer of antinuclear antibodies, elevation of serum anti‐DNA antibodies, depressed complement activity, thrombocytopenia and proteinuria, indicating that she had SLE. A week after starting treatment with prednisolone 35 mg/day, the thrombocytopenia improved, and following an increase in dosage to 60 mg/day the pleural effusion and ascites diminished after two weeks, and the serological abnormalities improved after two months. The neurological disturbances were unchanged in spite of injections of methylprednisolone 1 g/day for three days from the 89th day of her illness. Review of other cases reported to be improved neurologically, suggested that the earlier initiation of corticosteroids in higher dosage might be beneficial in transverse myelopathy m SLE.