Systemic lupus erythematosus: CNS vasculitis

Case contributed by Dr Devanshi Dharaiya

Presentation

Altered mental status and seizures.

Patient Data

Age: 45
Gender: Female

Axial FLAIR showing multiple patchy areas of hyperintensity at grey-white junction, likely ischemic in origin suggestive of CNS vasculitis.

Case Discussion

Rheumatological markers for systemic lupus erythematosus (SLE) were positive and indicated active disease.

Diagnosis of CNS vasculitis was made clinically and the risk of brain biopsy vs trial of steroids was weighed. The patient decided to trial of steroids and immunosuppressants.

After 2 months, the patient showed dramatic improvement clinically and on imaging after treatment with steroids and rituximab.

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Case information

rID: 30792
Case created: 4th Sep 2014
Last edited: 28th Nov 2015
Inclusion in quiz mode: Excluded

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