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Case ReportImages in Rheumatology

Rapid Progressive Cerebral Atrophy in Systemic Lupus Erythematosus

YASUHIRO KATSUMATA, YASUSHI KAWAGUCHI and HISASHI YAMANAKA
The Journal of Rheumatology December 2011, 38 (12) 2689; DOI: https://doi.org/10.3899/jrheum.110795
YASUHIRO KATSUMATA
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  • For correspondence: katsumata@ior.twmu.ac.jp
YASUSHI KAWAGUCHI
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HISASHI YAMANAKA
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Neuropsychiatric systemic lupus erythematosus (NPSLE) is a serious and potentially life-threatening manifestation of SLE that occurs in 37%–95% of cases and is associated with an increased risk of death1. Cerebral atrophy (i.e., cortical atrophy and ventricular dilation) determined by magnetic resonance imaging (MRI) was prevalent in 18% of patients with newly diagnosed SLE and was the most frequent abnormal finding by MRI2. MRI was more sensitive than brain histopathology for the presence of cerebral atrophy in NPSLE3.

A 30-year-old woman with a 5-year history of SLE had a flare with fever and disturbed consciousness. The initial MRI scan with fluid-attenuated inversion-recovery revealed multiple high-intensity areas in the deep white matter (Figure 1A). Stroke and infection were excluded following investigation. Accordingly, we diagnosed an acute confusional state (delirium) caused by SLE. Despite aggressive treatment, including steroid pulse therapy and pulsed intravenous cyclophosphamide, the patient’s consciousness rapidly deteriorated into coma. Four months later, we noted significant cerebral atrophy, characterized by a loss of brain volume, along with multiple continuous high-intensity areas (Figure 1B). She never recovered from coma and was transferred to another hospital.

Figure 1.
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Figure 1.

A. The initial MRI scan with fluid-attenuated inversion-recovery reveals multiple high-intensity areas in the deep white matter. B. Four months later, there is significant cerebral atrophy, characterized by a loss of brain volume, along with multiple continuous high-intensity areas.

Although mild brain atrophy on MRI is a common abnormal finding in NPSLE, rapidly progressing moderate to severe brain atrophy, as in this patient, has seldom been reported4. The MRI findings reflect the severe clinical outcome.

Footnotes

  • Supported by a grant from the Japanese Ministry of Health, Labor, and Welfare (Grant for Intractable Diseases).

REFERENCES

  1. 1.↵
    1. Hanly JG,
    2. Harrison MJ
    . Management of neuropsychiatric lupus. Best Pract Res Clin Rheumatol 2005;19:799–821.
    OpenUrlCrossRefPubMed
  2. 2.↵
    1. Petri M,
    2. Naqibuddin M,
    3. Carson KA,
    4. Wallace DJ,
    5. Weisman MH,
    6. Holliday SL,
    7. et al.
    Brain magnetic resonance imaging in newly diagnosed systemic lupus erythematosus. J Rheumatol 2008;35:2348–54.
    OpenUrlAbstract/FREE Full Text
  3. 3.↵
    1. Sibbitt WL Jr.,
    2. Brooks WM,
    3. Kornfeld M,
    4. Hart BL,
    5. Bankhurst AD,
    6. Roldan CA
    . Magnetic resonance imaging and brain histopathology in neuropsychiatric systemic lupus erythematosus. Semin Arthritis Rheum 2010;40:32–52.
    OpenUrlCrossRefPubMed
  4. 4.↵
    1. Katsumata Y,
    2. Harigai M,
    3. Kawaguchi Y,
    4. Fukasawa C,
    5. Soejima M,
    6. Kanno T,
    7. et al.
    Diagnostic reliability of magnetic resonance imaging for central nervous system syndromes in systemic lupus erythematosus: A prospective cohort study. BMC Musculoskelet Disord 2010;11:13.
    OpenUrlCrossRefPubMed
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1 Dec 2011
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Rapid Progressive Cerebral Atrophy in Systemic Lupus Erythematosus
YASUHIRO KATSUMATA, YASUSHI KAWAGUCHI, HISASHI YAMANAKA
The Journal of Rheumatology Dec 2011, 38 (12) 2689; DOI: 10.3899/jrheum.110795

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Rapid Progressive Cerebral Atrophy in Systemic Lupus Erythematosus
YASUHIRO KATSUMATA, YASUSHI KAWAGUCHI, HISASHI YAMANAKA
The Journal of Rheumatology Dec 2011, 38 (12) 2689; DOI: 10.3899/jrheum.110795
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