{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:13:12Z","timestamp":1792102392032,"version":"4.4.0"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease affecting multiple organs, including the kidneys, skin, vasculature, and central nervous system. Neuropsychiatric SLE (NPSLE) is a potentially life-threatening manifestation with diverse clinical presentations. We report a case of NPSLE presenting as myelitis in which contrast-enhanced spinal MRI showed no intramedullary abnormalities on repeated examinations (\u2018MRI-negative myelitis\u2019). The patient received high-dose intravenous glucocorticoids (GCs) and intravenous cyclophosphamide as induction therapy, after which anifrolumab was introduced; GCs were rapidly tapered with sustained neurological improvement. MRI-negative myelitis is a rare and diagnostically challenging NPSLE phenotype that requires a high index of suspicion. This case suggests that anifrolumab may have GC-sparing potential as part of maintenance management following induction therapy in selected patients, warranting further investigation.<\/jats:p>","DOI":"10.1093\/mrcr\/rxaf065","type":"journal-article","created":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T12:49:55Z","timestamp":1762692595000},"source":"Crossref","is-referenced-by-count":1,"title":["Anifrolumab as a glucocorticoid-sparing agent in MRI-negative myelitis associated with neuropsychiatric lupus: A case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2036-6216","authenticated-orcid":false,"given":"Masei","family":"Suda","sequence":"first","affiliation":[{"name":"Rheumatology, Suwa Central Hospital , Nagano ,","place":["Japan"]},{"name":"Immuno-Rheumatology Centre, St. Luke\u2019s International Hospital , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kouichi","family":"Dai","sequence":"additional","affiliation":[{"name":"Rheumatology, Suwa Central Hospital , Nagano ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiro","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Rheumatology, Suwa Central Hospital , Nagano ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoharu","family":"Muranaka","sequence":"additional","affiliation":[{"name":"Rheumatology, Suwa Central Hospital , Nagano ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Minoda","sequence":"additional","affiliation":[{"name":"Rheumatology, Suwa Central Hospital , Nagano ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Okada","sequence":"additional","affiliation":[{"name":"Immuno-Rheumatology Centre, St. Luke\u2019s International Hospital , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"2025112810272793900_ref1","doi-asserted-by":"crossref","first-page":"16039","DOI":"10.1038\/nrdp.2016.39","article-title":"Systemic lupus erythematosus","volume":"2","author":"Kaul","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"2025112810272793900_ref2","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1038\/s41584-018-0156-8","article-title":"Neuropsychiatric lupus: New mechanistic insights and future treatment directions","volume":"15","author":"Schwartz","year":"2019","journal-title":"Nat Rev Rheumatol"},{"key":"2025112810272793900_ref3","doi-asserted-by":"crossref","first-page":"968322","DOI":"10.3389\/fneur.2022.968322","article-title":"Persistent \u201cMRI-negative\u201d lupus myelitis: Disease presentation, immunological profile and outcome","volume":"13","author":"Das","year":"2022","journal-title":"Front Neurol"},{"key":"2025112810272793900_ref4","doi-asserted-by":"crossref","first-page":"2074","DOI":"10.1136\/ard.2010.130476","article-title":"EULAR recommendations for the management of systemic lupus erythematosus with neuropsychiatric manifestations: Report of a task force of the EULAR standing Committee for Clinical Affairs","volume":"69","author":"Bertsias","year":"2010","journal-title":"Ann Rheum Dis"},{"key":"2025112810272793900_ref5","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.coi.2020.10.014","article-title":"Type I interferon in the pathogenesis of systemic lupus erythematosus","volume":"67","author":"Postal","year":"2020","journal-title":"Curr Opin Immunol"},{"key":"2025112810272793900_ref6","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1002\/art.39962","article-title":"Anifrolumab, an anti\u2013interferon-\u03b1 receptor monoclonal antibody, in moderate-to-severe systemic lupus erythematosus","volume":"69","author":"Furie","year":"2017","journal-title":"Arthritis Rheumatol"},{"key":"2025112810272793900_ref7","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1056\/NEJMoa1912196","article-title":"Trial of anifrolumab in active systemic lupus erythematosus","volume":"382","author":"Morand","year":"2020","journal-title":"N Engl J Med"},{"key":"2025112810272793900_ref8","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1097\/WCO.0000000000000822","article-title":"Advanced neuroimaging in neuropsychiatric systemic lupus erythematosus","volume":"33","author":"Mackay","year":"2020","journal-title":"Curr Opin Neurol"},{"key":"2025112810272793900_ref9","doi-asserted-by":"publisher","first-page":"1267","DOI":"10.1002\/jmri.24563","article-title":"MRI in transverse myelitis","volume":"40","author":"Goh","year":"2014","journal-title":"J Magn Reson Imaging"},{"key":"2025112810272793900_ref10","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1002\/art.1780350410","article-title":"Interferon-alpha in lupus psychosis","volume":"35","author":"Shiozawa","year":"1992","journal-title":"Arthritis Rheum"},{"key":"2025112810272793900_ref11","doi-asserted-by":"crossref","first-page":"2218","DOI":"10.1093\/rheumatology\/ket294","article-title":"Inflammatory profile in cerebrospinal fluid of patients with headache as a manifestation of neuropsychiatric systemic lupus erythematosus","volume":"52","author":"Fragoso-Loyo","year":"2013","journal-title":"Rheumatology (Oxford)"},{"key":"2025112810272793900_ref12","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1080\/03009742.2024.2306053","article-title":"Refractory systemic lupus erythematosus with neuropsychiatric manifestations successfully treated with anifrolumab","volume":"53","author":"Kobayashi","year":"2024","journal-title":"Scand J Rheumatol"},{"key":"2025112810272793900_ref13","doi-asserted-by":"publisher","first-page":"1491","DOI":"10.1002\/art.21031","article-title":"Activation of the interferon-\u03b1 pathway identifies a subgroup of systemic lupus erythematosus patients with distinct serologic features and active disease","volume":"52","author":"Kirou","year":"2005","journal-title":"Arthritis Rheum"},{"key":"2025112810272793900_ref14","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1136\/annrheumdis-2021-221662","article-title":"Anti-RNP antibodies are associated with the interferon gene signature but not decreased complement levels in SLE","volume":"81","author":"Hubbard","year":"2022","journal-title":"Ann Rheum Dis"}],"container-title":["Modern Rheumatology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/mrcr\/advance-article-pdf\/doi\/10.1093\/mrcr\/rxaf065\/65253105\/rxaf065.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mrcr\/article-pdf\/9\/2\/rxaf065\/65253105\/rxaf065.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mrcr\/article-pdf\/9\/2\/rxaf065\/65253105\/rxaf065.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T15:27:34Z","timestamp":1764343654000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/mrcr\/article\/doi\/10.1093\/mrcr\/rxaf065\/8317962"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,7,25]]}},"URL":"https:\/\/doi.org\/10.1093\/mrcr\/rxaf065","relation":{},"ISSN":["2472-5625"],"issn-type":[{"value":"2472-5625","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025]]},"published":{"date-parts":[[2025]]},"article-number":"rxaf065"}}