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Bilateral optic neuritis in pediatric systemic lupus erythematosus with antiphospholipid antibody syndrome

Soumya Patra1, Sriram Krishnamurthy, Anju Seth

  • 1Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi, 110001, India. dr_soumyapatra@rediffmail.com

Indian Journal of Pediatrics
|October 1, 2010
PubMed

Insights

Bilateral optic neuritis is a rare complication in pediatric systemic lupus erythematosus. This case highlights severe vision loss despite treatment, emphasizing the challenges in managing this condition.

Area of Science:

  • Pediatric Rheumatology
  • Neuro-ophthalmology

Background:

  • Pediatric systemic lupus erythematosus (SLE) can present with diverse neurological manifestations.
  • Bilateral optic neuritis is an exceptionally rare complication of pediatric SLE.

Observation:

  • An 11-year-old girl with SLE presented with fever, anemia, hepatosplenomegaly, and headache.
  • She rapidly developed vision loss to no light perception with bilateral optic neuritis.
  • Cerebral venous sinus thrombosis was also identified.

Findings:

  • The patient exhibited autoimmune hemolytic anemia, thrombocytopenia, and positive anti-dsDNA and anti-phospholipid antibodies.
  • Treatment included methylprednisolone, cyclophosphamide, and anticoagulation.
  • Despite achieving remission, the patient developed irreversible bilateral optic atrophy and persistent vision loss.

Implications:

  • This case underscores the severe visual morbidity associated with optic neuritis in pediatric SLE.
  • Early recognition and aggressive immunosuppressive therapy are crucial, though visual outcomes can be poor.
  • Further research into novel therapeutic strategies for neuro-SLE complications is warranted.

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