Clinical presentation of a neuropsychiatric lupus patient with symmetrical basal ganglia lesions containing cytotoxic oedema cores surrounded by vasogenic oedema. (2nd January 2020)

• Record Type: Journal Article
• Authors: Tsubouchi, Syoko; Hayashi, Haeru; Tahara, Koichiro; Ishii, Kayo; Yasuda, Takuya; Yamamoto, Yusuke; Mizuuchi, Takahiro; Mori, Hiroaki; Tago, Mayu; Kato, Eri; Sawada, Tetsuji
• Is Part Of: Modern rheumatology case reports. Volume 4:Number 1(2020)
• Page Start: 39
• Page End: 46
• Publication Date: 2020-01-02
• Subjects: Systemic lupus erythematosus (SLE) -- neuropsychiatric SLE (NPSLE) -- basal ganglia -- vasogenic oedema -- cytotoxic oedema; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1080/24725625.2019.1651955
• Languages: English
• ISSNs: 2472-5625

Abstract

Abstract: Neuropsychiatric (NP) manifestations of systemic lupus erythematosus (SLE) are diverse, but involvement of basal ganglia is rare. We describe here a 28-year-old woman with NPSLE presenting aseptic meningitis accompanied by elevated interleukin-6 levels in the cerebrospinal fluid, who developed symmetrical basal ganglia lesions, containing a cytotoxic oedematous core, surrounded by vasogenic oedema upon magnetic resonance imaging. We were able to observe these lesions from a de novo appearance during the disease onset to its disappearance during immunosuppressive treatment. Reversibility upon immunosuppressive treatment indicated that autoimmune mediated mechanisms could contribute to the basal ganglia lesions in NPSLE.