title: Systemic lupus erythematosus associated with transverse myelitis and parkinsonian symptoms.
abstract: A 31-year old woman developed transverse myelitis after 10 years remission since she was first diagnosed as systemic lupus erythematosus. Although pulse methyl prednisolone resolved her myelitis, Parkinson-like symptoms developed subsequently after reduction of steroid. Treatments including apheresis did not improve her Parkinson-like symptoms such as rigidity, akinesia, impairment of speech and mask-like facial expression. Levodopa was effective as a symptomatic therapy. Orally administered cyclophosphamide eventually led her to remission and withdrawal from levodopa. Her clinical course and the absence of other possible causes prompted us to conclude that Parkinsonian symptoms as well as transverse myelitis may have developed as manifestations of central nervous system lupus.
authors.affiliation: Second Department of Internal Medicine, Hirosaki University School of Medicine, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Osawa
authors.forename: H
authors.initials: H
authors.lastname: Yamabe
authors.forename: M
authors.initials: M
authors.lastname: Kaizuka
authors.forename: N
authors.initials: N
authors.lastname: Tamura
authors.forename: S
authors.initials: S
authors.lastname: Tsunoda
authors.forename: K I
authors.initials: KI
authors.lastname: Shirato
authors.forename: K
authors.initials: K
authors.lastname: Okumura
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology; D000978:Antiparkinson Agents / Q000494:pharmacology; D003520:Cyclophosphamide / Q000494:pharmacology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D007980:Levodopa / Q000494:pharmacology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D009187:Myelitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D010302:Parkinson Disease, Secondary / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012263:Ribonucleosides / Q000494:pharmacology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000978:Antiparkinson Agents; D007166:Immunosuppressive Agents; D012263:Ribonucleosides; D007980:Levodopa; C010052:mizoribine; D003520:Cyclophosphamide