Multiple brain calcifications in a patient with systemic lupus erythematosus

Area of Science:

• Neurology
• Rheumatology
• Radiology

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organs.
• Neuropsychiatric manifestations (NPSLE) are common in SLE, presenting with diverse neurological and psychiatric symptoms.
• Cerebral calcifications are an uncommon finding in NPSLE.

Observation:

• A rare case of severe neuropsychiatric SLE is presented.
• Cerebral Computed Tomography (CT) revealed cerebral atrophy.
• Multiple calcifications were observed in the paraventricular regions, basal ganglia, cortex, cerebral white matter, and cerebellum.

Findings:

• The observed cerebral calcifications are likely secondary to necrotic foci.
• These necrotic foci are attributed to repeated episodes of vascular inflammation, a known complication in SLE.
• The extensive calcifications indicate significant and potentially chronic vascular damage within the brain.

Implications:

• This case highlights the importance of neuroimaging in diagnosing and understanding the pathophysiology of severe NPSLE.
• Recognizing such calcifications may aid in predicting disease severity and long-term neurological outcomes.
• Further research into the mechanisms of vascular inflammation and calcification in NPSLE is warranted.