Systemic lupus erythematosus presenting with neurological disorders

Area of Science:

• Neurology
• Rheumatology
• Immunology

Background:

• Systemic lupus erythematosus (SLE) is a complex autoimmune disease with diverse clinical presentations.
• Neurological manifestations are common in SLE but can sometimes precede systemic symptoms.
• The nervous system can be a primary target in SLE, leading to a wide range of neurological deficits.

Purpose of the Study:

• To describe six cases of patients presenting with varied neurological manifestations as the initial or predominant sign of SLE.
• To highlight the peculiarity of neurological disorders being the sole or main manifestation of SLE for extended periods.
• To evaluate the treatment response and prognosis in these specific SLE patient cohorts.

Main Methods:

• Case series describing six patients with neurological symptoms heralding SLE.
• Detailed clinical evaluation including neurological examinations and diagnostic workup for SLE.
• Assessment of treatment response, particularly to corticosteroid therapy.

Main Results:

• Patients presented with diverse neurological issues: epileptic seizures, stroke, polyradiculoneuropathy, transverse myelopathy, and multiple sclerosis-like disorders.
• Neurological symptoms were the primary or only SLE manifestation for many years in these patients.
• Five out of six patients showed a favorable prognosis with prolonged remission following corticosteroid treatment.

Conclusions:

• Neurological manifestations can be the initial and dominant feature of systemic lupus erythematosus.
• The nervous system may be the principal target in certain SLE presentations.
• Corticosteroid therapy is effective in achieving prolonged remission in a majority of these patients.