title: Simultaneous presentation of acute disseminated encephalomyelitis (ADEM) and systemic lupus erythematosus (SLE) after enteroviral infection: can ADEM present as the first manifestation of SLE?
abstract: Central Nervous System (CNS) involvement of Systemic Lupus Erythematosus (SLE) includes a broad range of neuropsychiatric syndromes. Acute Disseminated Encephalomyelitis (ADEM) is a demyelinating CNS disorder characterized by encephalopathy and multifocal lesions predominantly involving the white matter on brain magnetic resonance imaging. ADEM associated with SLE has been only rarely reported. We report an unusual case of a 17-year-old girl who developed ADEM after enteroviral infection as the first manifestation of SLE. The authors emphasize that the patient's illness was preceded by enteroviral infection and that ADEM occurred before any other symptoms of SLE, which makes this case unique.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: J-M
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: C-N
authors.initials: CN
authors.lastname: Son
authors.affiliation: Department of Radiology, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: H W
authors.initials: HW
authors.lastname: Chang
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea mdkim9111@gmail.com.
authors.forename: S-H
authors.initials: SH
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000974:Antibodies, Antinuclear / Q000276:immunology; D001706:Biopsy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004673:Encephalomyelitis, Acute Disseminated / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D004769:Enterovirus Infections / Q000473:pathology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000821:virology; D020945:Lupus Vasculitis, Central Nervous System / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000008:administration & dosage; D020551:Pulse Therapy, Drug / Q000379:methods
chemical_list: D000893:Anti-Inflammatory Agents; D000974:Antibodies, Antinuclear; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D008775:Methylprednisolone
keywords: Systemic lupus erythematosus; acute disseminated encephalomyelitis; enteroviral infection