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Journal of Korean Neurosurgical Society 1998;27(2): 268-273.
Systemic Lupus Erythematosus with Central Nervous System Involvement: Case Report.
Jeong Woon Park, Moo Seong Kim, Sun Il Lee, Yong Tae Jung, Soo Chun Kim, Jae Hong Sim
Department of Neurosurgery, College of Medicine, Inje University, Paik Hospital, Pusan, Korea.
ABSTRACT
Systemic lupus erythematosus(SLE) is a disease of unknown cause in which tissues and cells are damaged by pathogenic autoantibodies and immune complexes. Clinical manifestations which fulfill American Rheumatism Association criteria for a diagnosis of SLE include malar or discoid rash, photosensitivity, oral ulcers, arthritis, serositis, renal, neurologic, hematologic or immunologic disorder, and antinuclear antibodies. Central nervous system (CNS) events may be single or multiple. Clinical manifestations of CNS involvement include organic brain syndromes, focal infarcts, headache, transverse myelitis, optic neuritis, cranial nerve palsies, depression, and anxiety. A 34-year-old female presented with generalized seizure. Antinuclear antibody and antibody to Sm were positive, and low levels of C3 and C4 were detected. On MRI, mild, non-enhancing, low signal intensity was seen on T1 weighted images, and illdefined higher intensities on T2 weighted images. On stereotactic biopsy, three pieces of yellowish material were obtained. Microscopically, coagulative necrosis and neutrophilic infiltration were seen, and the patient underwent steroid therapy. Two months later, MRI no longer showed abnormal signal intensity.
Key Words: Systemic lupus erythematosus; Central nervous system; Generalized seizure; Magnetic resonance imaging; Stereotactic biopsy
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