Presentation
Altered mental status and seizures.
Patient Data
Age: 45 years
Gender: Female
From the case:
Systemic lupus erythematosus - CNS vasculitis
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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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