Systemic Lupus Erythematosus Presenting as Neuroretinitis

Area of Science:

• Ophthalmology
• Nephrology
• Rheumatology

Background:

• Neuroretinitis involves inflammation of the retina and optic nerve, presenting with optic disc edema and exudates.
• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
• Early recognition of SLE symptoms is crucial for timely intervention and management.

Observation:

• A 17-year-old female presented with headache, nausea, periorbital edema, and splenomegaly.
• Initial assessments revealed pancytopenia, albuminuria, and elevated ESR, followed by bilateral vision blurring.
• Ophthalmological examination confirmed bilateral neuroretinitis.

Findings:

• Serological tests were positive for antinuclear antibody (ANA) and anti-double-stranded DNA (anti-ds DNA).
• Renal biopsy indicated diffuse global proliferative lupus nephritis (Class IV-G (A)) with active lesions.
• The patient was diagnosed with SLE presenting with neuroretinitis.

Implications:

• Neuroretinitis can be an initial ocular manifestation of SLE, particularly in young individuals.
• This case underscores the importance of a comprehensive diagnostic approach in patients with unexplained neuroretinitis.
• Prompt diagnosis and management of SLE are essential to prevent severe complications and preserve vision.