[Overlap syndrome of systemic lupus erythematosus and dermatomyositis presented a large demyelinating subcortical lesion mimicking brain tumor and high level of CSF antineuronal and serum anti-ribosomal P antibodies].
We reported a 50-year-old man with an overlap syndrome of dermatomyositis and SLE, whose magnetic resonance image of the brain showed a rapidly increasing large tumor-like focal lesion unequally enhanced by Gd-DTPA in the left frontal lobe. Its pathological finding by the brain biopsy was fibrinoid necrosis, inflammatory cell aggregation around blood vessels and many myelin-laden macrophages with central necrosis. Although many cases of blood vessel injury are reported in CNS lupus, in this case the brain lesion partly took reversible course and neural symptoms such as paresis were slight and the lesion well responded to steroid. Moreover we considered that the measurement of serum anti-ribosomal P and CSF antineuronal antibodies are useful to diagnose cases as CNS lupus.
Kano
Satoko
S
Department of Neurology, Yokohama Rosai Hospital.
Nakamori
Tomoki
T
Imafuku
Ichiro
I
Sudo
Akira
A
Inomori
Shigeo
S
Murayama
Shigeo
S
Kunimoto
Masanari
M
D001323:Autoantibodies / Q000097:blood* / Q000134:cerebrospinal fluid*; D001932:Brain Neoplasms / Q000175:diagnosis*; D003711:Demyelinating Diseases / Q000175:diagnosis* / Q000209:etiology; D003882:Dermatomyositis / Q000150:complications*; D003937:Diagnosis, Differential; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009474:Neurons / Q000276:immunology*; D015800:Protozoan Proteins; D012269:Ribosomal Proteins / Q000276:immunology*
D001323:Autoantibodies; C064601:L12E protein, Trypanosoma cruzi; D015800:Protozoan Proteins; D012269:Ribosomal Proteins