Search strategy Pubmed, 29-04-2020
(("Lupus Erythematosus, Systemic"[mesh] OR "systemic lupus erythematosus"[tw] OR "SLE"[tw] OR "NPSLE"[tw] OR "Lupus"[tw]) AND ("Myelitis, Transverse"[Mesh] OR "myelitis transversa"[tw] OR "myelitis transverse"[tw] OR "transverse myelitis"[tw] OR "Demyelinative Myelitis"[tw] OR "Necrotising Myelitis"[tw] OR "Necrotizing Myelitis"[tw] OR "Myelitis"[mesh] OR "myelitis"[tw] OR "myelopathy"[tw] OR myelopath*[tw]) NOT ("Animals"[mesh] NOT "Humans"[mesh]) AND (english[la] OR dutch[la] OR german[la]))
Supplementary figure 1 Literature review, article selection process
Supplementary file II
Quality assessment
Risk of bias was considered high in case-reports and case-series, as selective reporting is present by default and clinical outcome is not predefined. Risk of bias varied among the observational studies: the majority of studies identified patients with TM by retrospective chart review of SLE patients in a given time period in one hospital. Some articles reported the total amount of patients identified and included, showing the most transparency about the process selection. 37, 41, 44, 45, 48, 50, 52 Other studies did not mention how many patients were originally identified 1, 24, 40, 46, 47,51-52 and two studies collected data by inviting clinicians to participate and reporting cases, leading to a higher risk of bias. 23, 49 Clinical outcome was predefined in most studies, using validated scales such as the American Spinal Injury Association scale for spinal cord injury. In other studies, outcome of individual participants was described in great detail and therefore the decision rules defined regarding clinical outcome in the Method sections could be applied easily. 25,27,32 Only one study did not have a clear definition what was considered recovery/improvement in patients with TM. 28
Supplementary file III
Supplementary table 1 Data extracted from case-reports and case-series, ordered chronologically
Ref
Sex
Age
(yrs)
SLEa
Onset
(yrs)b
sMRI
F
51
F
40
F
23
NA
HD: +/-
Notes: + = present or abnormal; - = absent or normal; NA = not available. a Diagnosis of SLE according to ACR criteria b SLE duration in years c Outcome: ++ = full recovery; + = nearly complete recovery; +/- = partial improvement; - = no improvement; -- = death
Abbreviations: CSF, cerebrospinal fluid; HD, during hospital stay or at hospital discharge; OCB, oligoclonal bands; sMRI, MRI of the spinal cord; ST, short term, between hospital discharge – 6 months; LT, long term (longer than 6 months); WBC, white blood cells
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