J Korean Neurosurg Soc.  1998 Feb;27(2):268-273.

Systemic Lupus Erythematosus with Central Nervous System Involvement: Case Report

• Park JW
• Kim MS
• Lee SI
• Jung YT
• Kim SC
• Sim JH

Abstract

Systemic lupus erythematosus(SLE) is a disease of unknown cause in which tissues and cells are damaged by pathogenic autoantibodies and immune complexes. Clinical manifestations which fulfill American Rheumatism Association criteria for a diagnosis of SLE include malar or discoid rash, photosensitivity, oral ulcers, arthritis, serositis, renal, neurologic, hematologic or immunologic disorder, and antinuclear antibodies. Central nervous system (CNS) events may be single or multiple. Clinical manifestations of CNS involvement include organic brain syndromes, focal infarcts, headache, transverse myelitis, optic neuritis, cranial nerve palsies, depression, and anxiety. A 34-year-old female presented with generalized seizure. Antinuclear antibody and antibody to Sm were positive, and low levels of C3 and C4 were detected. On MRI, mild, non-enhancing, low signal intensity was seen on T1 weighted images, and illdefined higher intensities on T2 weighted images. On stereotactic biopsy, three pieces of yellowish material were obtained. Microscopically, coagulative necrosis and neutrophilic infiltration were seen, and the patient underwent steroid therapy. Two months later, MRI no longer showed abnormal signal intensity.

Keyword

Systemic lupus erythematosus; Central nervous system; Generalized seizure; Magnetic resonance imaging; Stereotactic biopsy

MeSH Terms

Adult
Antibodies, Antinuclear
Antigen-Antibody Complex
Anxiety
Arthritis
Autoantibodies
Biopsy
Brain
Central Nervous System*
Cranial Nerve Diseases
Depression
Diagnosis
Exanthema
Female
Headache
Humans
Lupus Erythematosus, Systemic*
Magnetic Resonance Imaging
Myelitis, Transverse
Necrosis
Neutrophils
Optic Neuritis
Oral Ulcer
Rheumatic Diseases
Seizures
Serositis
Antibodies, Antinuclear
Antigen-Antibody Complex
Autoantibodies