[Neuro-ophthalmologic complications of disseminated lupus erythematosus].
BACKGROUND
Systemic lupus erythematosus (SLE) is a multisystemic inflammatory disease of unknown etiology. Physiopathology includes small vessel occlusion and auto-antibody production. Neuro-ophthalmic complications can be detected in 10-30% of SLE cases. Further, some patients can present with neuro-ophthalmic complications prior to diagnosis of SLE.


METHODS
We report seven cases of neuro-ophthalmic complications of SLE demonstrating lesions from the retina to the brain. The other possible manifestations of SLE will be reviewed.


RESULTS
Two cases were not yet diagnosed with SLE when neuro-ophthalmic disease occurred. Anti-double stranded DNA antibodies were detected at a very high titer, suggesting SLE, later confirmed by rheumatologists.


CONCLUSIONS
Ophthalmologists should be aware of the unusual patient presenting with a neuroophthalmic disorder prior to the diagnosis of SLE. In such cases, autoantibodies should be sought. Antinuclear antibodies are very sensitive but non specific for SLE. Anti-double stranded DNA antibodies are specific for SLE and elevated titer should raise the suspicion of undiagnosed SLE.
Borruat
F X
FX
Hôpital Ophtalmique Jules Gonin, Lausanne.
Prado
T
T
Strominger
M
M
Schatz
N J
NJ
Glaser
J S
JS
D000328:Adult; D000974:Antibodies, Antinuclear / Q000032:analysis; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000276:immunology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000276:immunology; D012164:Retinal Diseases / Q000175:diagnosis* / Q000276:immunology; D015354:Vision, Low / Q000175:diagnosis* / Q000276:immunology
D000974:Antibodies, Antinuclear
Complications neuro-ophtalmologiques du lupus érythémateux disséminé.