title: Fulminant onset of cerebral immunocomplex vasculitis as first manifestation of neuropsychiatric systemic lupus erythematosus (NPSLE).
abstract: Fulminant onset of neuropsychiatric symptoms as first manifestation of neuropsychiatric systemic lupus erythematosus (NPSLE) is rare and diagnosis is difficult if only one organ is involved. Here, we report the case of a previously healthy woman who presented with a clinical syndrome most compatible with acute onset of NPSLE. However, American College of Rheumatology (ACR) criteria were not sufficiently met. Brain biopsy showed an autoimmune complex vasculitis consistent with central nervous system (CNS) lupus. Because the prognosis of SLE-related CNS involvement is poor, aggressive immunosuppressive treatment was initiated using methylprednisolone in combination with cyclophosphamide.
authors.affiliation: Department of Neurology, Ruprecht Karls University Heidelberg, Heidelberg, Germany. Timolaos.Rizos@med.uni-heidelberg.de
authors.forename: T
authors.initials: T
authors.lastname: Rizos
authors.forename: M
authors.initials: M
authors.lastname: Siegelin
authors.forename: S
authors.initials: S
authors.lastname: Hähnel
authors.forename: B
authors.initials: B
authors.lastname: Storch-Hagenlocher
authors.forename: A
authors.initials: A
authors.lastname: Hug
mesh_terms: D001706:Biopsy; D001921:Brain / Q000473:pathology*; D003520:Cyclophosphamide / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D020945:Lupus Vasculitis, Central Nervous System / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011379:Prognosis
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D008775:Methylprednisolone