Systemic lupus erythematosus: CNS vasculitis

Case contributed by Dr Devanshi Dharaiya


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
Published: 7th Sep 2014
Last edited: 14th Aug 2019
Inclusion in quiz mode: Excluded

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