title: Unusual case of tetraparesis in a patient with systemic lupus erythematosus.
abstract: We describe the case of a 67-year-old Asian female patient suffering from severe systemic lupus erythematosus (SLE), including biopsy-proven glomerulonephritis, since the age of 40 who was admitted for tetraparesis. Neurological examination confirmed proximal muscular weakness, hypoesthesia and diminished tendon reflexes. The patient suffered from extremely severe Jaccoud's arthropathy. Magnetic resonance imaging (MRI) demonstrated severe narrowing of the upper spinal canal due to a soft tissue mass surrounding the odontoid process, assumed to be a synovial pannus, causing myelopathy. The patient was treated with three intravenous pulses of methylprednisolone with prompt and full clinical recovery. Follow-up MRI confirmed considerable regression of the pannus. Inflammatory transverse myelopathy is the most common explanation for para/tetraparesis in SLE. However, in this case, the symptoms were caused by atlantoaxial synovitis, which is more typical for rheumatoid arthritis.
authors: Departments of Rheumatology.
authors: A
authors: A
authors: Ishchenko
authors: Radiology.
authors: J
authors: J
authors: Malghem
authors: Orthopaedic Medecine, Université catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
authors: X
authors: X
authors: Banse
authors: Departments of Rheumatology frederic.houssiau@uclouvain.be.
authors: F A
authors: FA
authors: Houssiau
mesh_terms: D000368:Aged; D001268:Atlanto-Axial Joint / Q000473:pathology; D005260:Female; D005921:Glomerulonephritis / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000473:pathology; D008775:Methylprednisolone / Q000008:administration & dosage; D011782:Quadriplegia / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone
keywords: Jaccoud’s arthropathy; MRI; Systemic lupus erythematosus; atlantoaxial joint; tetraparesis