Opsoclonus-myoclonus syndrome associated with Mycoplasma pneumoniae infection in an elderly patient.

Opsoclonus-myoclonus-ataxia syndrome (OMS) is a rare movement disorder characterized by chaotic saccadic, high amplitude, multidirectional and involuntary eye movements usually associated with myoclonus affecting the head, trunk, limbs and signs of cerebellar ataxia, especially the inability to stand and walk. We report a case of a 68 years-old woman, with previous history of diabetes mellitus and systemic hypertension that was referred for evaluation due to headache and low fever for three days. One day after the admission, she developed spatial and temporal disorientation and high-fever (39 °C). On her fourth day in-hospital, while still disoriented, diffuse limb myoclonia and intermittent, multidirectional and chaotic eye movements were noticed. Sorological tests and sputum Mycoplasma real-time PCR were positive on seventh day in-hospital. Patient was treated with Azithromycin and IV Immunoglobulin for five days. On third day after treatment it was noticed significant improvement of ataxia and myoclonia. Completely recovery after macrolydes and IVIg treatment, absence of a malignant neoplasia and knowledge of this entity in pediatric population support that parainfectious OMS associated with M. pneumoniae infections should be considered in the differential diagnosis of OMS in adults.

Translation into Brazilian Portuguese, cultural adaptation and validatation of the systemic lupus erythematosus quality of life questionnaire (SLEQOL).

OBJECTIVES: Translate into Brazilian Portuguese, cross cultural adaptation and assess the reliability and validity of the Systemic Lupus Erythematosus Quality of Life Questionnaire (SLEQOL). STUDY POPULATION: 107 SLE patients, answered the SLEQOL questionnaire. TRANSLATION: into Portuguese and cross-cultural adaptation was performed in accordance with studies on questionnaire translation methodology into other languages. RELIABILITY: Was analyzed using three interviews with different interviewers, two on the same day (interobserver) and the third within 14 days of the first assessment (intraobserver). VALIDITY: Validity was assessed by correlating clinical and quality of life parameters with the SLEQOL. STATISTICAL ANALYSIS: A descriptive analysis of the study sample. Reproducibility was assessed using an intraclass correlation coefficient (ICC). Internal consistency was assessed using Cronbach's alpha coefficient. To assess validity we used Pearson's correlation coefficient. Five percent was the level of significance adopted for all statistical tests. RESULTS: The SLEQOL was translated and culturally adapted. The main findings were: a 0.807 internal consistency correlation coefficient for all questions and domains. The inter and intraobserver correlation coefficients were 0.990 and 0.969 respectively. Validation showed good correlation with theSF-36 and poor correlation with lupus activity or damage indices. CONCLUSIONS: The quality of life parameter has been increasingly taken into account for chronic diseases. To date there are no tools to assess Quality of Life in Systemic Lupus Erythematosus (SLE) written in the Portuguese language. The questionnaire is valid and reliable for SLE patients in Brazil.