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Chorea in systematic lupus erythematosus; a case report
Yo Ueda1, Yuko Takahashi, Hiroyuki Yamashita
1Division of Rheumatic Diseases, National Center for Global Health and Medicine.
Summary
Systemic lupus erythematosus (SLE) can cause movement disorders like chorea. This case highlights both immune and ischemic factors contributing to chorea in an SLE patient on maintenance therapy.
Area of Science:
- Neurology
- Rheumatology
- Immunology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease.
- Movement disorders, such as chorea, can be a rare neurological manifestation of SLE.
- Anti-phospholipid antibodies are implicated in SLE-associated neurological complications.
Observation:
- A 33-year-old female with a history of SLE and hemophagocytic syndrome developed acute chorea and hemianopia.
- The patient was on maintenance therapy with prednisolone and tacrolimus.
- Neurological symptoms presented with elevated anti-double-stranded DNA antibodies and anti-cardiolipin IgG.
Findings:
- Magnetic resonance imaging revealed ischemic changes in the basal ganglia.
- Treatment involved corticosteroids, immunosuppressants, antithrombotics, and dopamine antagonists.
- Partial symptom remission was achieved, suggesting a complex etiology.
Implications:
- This case underscores the potential for both immunological and ischemic mechanisms in SLE-related chorea.
- Early recognition and multimodal treatment are crucial for managing neurological complications in SLE.
- Further research is needed to elucidate the precise pathophysiology of chorea in SLE.
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