Neuropsychiatric Systemic Lupus Erythematosus: A Diagnostic Conundrum
A 70-year-old man presented with complaints of rapid cognitive decline and new onset leukopenia. The patient had a 17-year history of refractory seizures. Detailed review of symptoms and investigations revealed the patient met American College of Rheumatology (ACR) diagnostic criteria for systemic l...
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| Format: | Online |
| Language: | English |
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Elmer Press
2016
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5012247/ |
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pubmed-5012247 |
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pubmed-50122472016-09-15 Neuropsychiatric Systemic Lupus Erythematosus: A Diagnostic Conundrum Joseph, Vivek Anil, Rahul Aristy, Sary Case Report A 70-year-old man presented with complaints of rapid cognitive decline and new onset leukopenia. The patient had a 17-year history of refractory seizures. Detailed review of symptoms and investigations revealed the patient met American College of Rheumatology (ACR) diagnostic criteria for systemic lupus erythematosus (SLE). The patient had high titer ANA with a strongly positive dsDNA. Immunosuppressive therapy with hydroxychloroquine and mycophenolate mofetil led to significant improvement in cognition and seizures. Neuropsychiatric SLE should be considered a potential differential diagnosis for patients presenting with seizures or cognitive decline. Moreover, neuropsychiatric manifestations especially seizures are an early event in the disease course of SLE. Hence, we believe that early diagnosis of SLE by neuropsychiatric manifestations will not only lead to better control of CNS symptoms but early immunosuppressive therapy could control the progression of the underlying autoimmune disease. Elmer Press 2016-10 2016-08-30 /pmc/articles/PMC5012247/ /pubmed/27635183 http://dx.doi.org/10.14740/jocmr2698w Text en Copyright 2016, Joseph et al. http://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| repository_type |
Open Access Journal |
| institution_category |
Foreign Institution |
| institution |
US National Center for Biotechnology Information |
| building |
NCBI PubMed |
| collection |
Online Access |
| language |
English |
| format |
Online |
| author |
Joseph, Vivek Anil, Rahul Aristy, Sary |
| spellingShingle |
Joseph, Vivek Anil, Rahul Aristy, Sary Neuropsychiatric Systemic Lupus Erythematosus: A Diagnostic Conundrum |
| author_facet |
Joseph, Vivek Anil, Rahul Aristy, Sary |
| author_sort |
Joseph, Vivek |
| title |
Neuropsychiatric Systemic Lupus Erythematosus: A Diagnostic Conundrum |
| title_short |
Neuropsychiatric Systemic Lupus Erythematosus: A Diagnostic Conundrum |
| title_full |
Neuropsychiatric Systemic Lupus Erythematosus: A Diagnostic Conundrum |
| title_fullStr |
Neuropsychiatric Systemic Lupus Erythematosus: A Diagnostic Conundrum |
| title_full_unstemmed |
Neuropsychiatric Systemic Lupus Erythematosus: A Diagnostic Conundrum |
| title_sort |
neuropsychiatric systemic lupus erythematosus: a diagnostic conundrum |
| description |
A 70-year-old man presented with complaints of rapid cognitive decline and new onset leukopenia. The patient had a 17-year history of refractory seizures. Detailed review of symptoms and investigations revealed the patient met American College of Rheumatology (ACR) diagnostic criteria for systemic lupus erythematosus (SLE). The patient had high titer ANA with a strongly positive dsDNA. Immunosuppressive therapy with hydroxychloroquine and mycophenolate mofetil led to significant improvement in cognition and seizures. Neuropsychiatric SLE should be considered a potential differential diagnosis for patients presenting with seizures or cognitive decline. Moreover, neuropsychiatric manifestations especially seizures are an early event in the disease course of SLE. Hence, we believe that early diagnosis of SLE by neuropsychiatric manifestations will not only lead to better control of CNS symptoms but early immunosuppressive therapy could control the progression of the underlying autoimmune disease. |
| publisher |
Elmer Press |
| publishDate |
2016 |
| url |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5012247/ |
| _version_ |
1613644064289193984 |