Two case reports indicating the dilemma in diagnosing lupus cerebritis.
Systemic Lupus Erythematosus (SLE) is a connective-tissue disorder commonly affecting females of reproductive age group. Lupus Cerebritis is a serious neurological complication encountered in a good percentage of SLE cases. In this report, we discuss two Lupus Cerebritis patients, who were successfully diagnosed and treated. The first case, presented with generalized seizure, severe metabolic acidosis, and shock, with a history of fever of one-month duration. The second case manifested with an attack of generalized seizure after suffering from low-grade intermittent fever and joint pains for a duration of one-and-a-half months. Central Nervous System (CNS) involvement in SLE is caused by an inflammatory response of the autoimmune system, precipitated by an increased concentration of cytokines. Prompt identification of Lupus Cerebritis is extremely difficult, mainly because there is no single laboratory or radiological confirmatory test. Assessment of the clinical features and neurological signs, along with detection of antibodies in the serum and cerebrospinal fluid are necessary to arrive at a diagnosis. Lupus Cerebritis should be included in the provisional diagnosis of a female patient of reproductive age group, who presents with complicated neurological manifestations and with no clear-cut clinical, pathological, or image finding.
Medical Intensive Care Unit, The Misson Hospital, Durgapur, West Bengal, India.
Dharitri
D
Goswami
Department of Medicine, The Misson Hospital, Durgapur, West Bengal, India.
Shuddhosatta
S
Chatterjee
Department of Medicine, The Misson Hospital, Durgapur, West Bengal, India.
Bashar Imam
BI
Ahmad
Medical Intensive Care Unit, The Misson Hospital, Durgapur, West Bengal, India.
Shantanu
S
Das
Anti phospholipid antibody; antidouble stranded DNA; antinuclear antibody; lupus cerebritis; polyserositis; systemic lupus erythematosus