Hydrocephalus in an elderly man with systemic lupus erythematosus.
A 71-year-old man presented with quadriplegia, seizures, dysarthria, motor aphasia and urinary incontinence lasting for several years. The development of proteinuria and increased susceptibility to infections brought the physician's attention to possible underlying autoimmune diseases. Laboratory investigations revealed evidence for systemic lupus erythematosus (SLE) and antiphospholipid syndrome. Imaging studies showed obstructive hydrocephalus. Several courses of methylprednisolone therapies followed by maintenance therapy with low-dose steroid, ventriculoperitoneal shunt, and antihypertensives improved the proteinuria and dysarthria but not the urinary incontinence or dementia. A thromboembolic event in the central nervous system secondary to phospholipid antibodies or lupus activity may represent a pathogenetic basis for hydrocephalus. When encountering a patient with hydrocephalus but without apparent predisposing factors, it is always important to include SLE as a differential diagnosis.
Chen
Wei-Sheng
WS
Division of Allergy, Immunology and Rheumatology, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University, Taipei 112, Taiwan.
Wu
Tsai-Hung
TH
Chou
Chung-Tei
CT
Tsai
Chang-Youh
CY
D000368:Aged; D016736:Antiphospholipid Syndrome / Q000150:complications; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology*; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male