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05:39
Dermoscopy Aids in the Diagnosis of Discoid Lupus Erythematosus
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688
Reversible Cognitive Dysfunction in Elderly-onset Systemic Lupus Erythematosus, Successfully Treated with Aggressive
Yuya Fujita1, Shoichi Fukui1,2, Midori Ishida1
1Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan.
Internal Medicine (Tokyo, Japan)
|May 22, 2018
Summary
Systemic lupus erythematosus (SLE) can cause neuropsychiatric issues like cognitive decline and gait problems in older adults. Prompt corticosteroid and cyclophosphamide treatment led to full cognitive recovery and gait improvement in a 70-year-old patient.
Area of Science:
- Neurology
- Immunology
- Rheumatology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
- Neuropsychiatric involvement is a serious complication of SLE, particularly in elderly patients.
- Early recognition and management of neuropsychiatric SLE (NPSLE) are crucial for patient outcomes.
Observation:
- A 70-year-old Japanese woman with SLE presented with significant gait disturbance and cognitive dysfunction.
- Magnetic resonance imaging revealed bilateral putaminal hyperintensities, suggesting central nervous system involvement.
- Elevated cerebrospinal fluid interleukin-6 levels indicated an active inflammatory process.
Findings:
- The patient was diagnosed with neuropsychiatric SLE based on clinical symptoms, imaging, and inflammatory markers.
- Treatment with corticosteroids and intravenous cyclophosphamide was initiated.
- The patient experienced a complete recovery of cognitive function and marked improvement in gait disturbance.
Implications:
- This case highlights the importance of recognizing and managing neuropsychiatric complications in elderly SLE patients.
- Aggressive immunosuppressive therapy can effectively reverse neurological deficits in NPSLE.
- Further research into the pathogenesis and optimal treatment strategies for NPSLE is warranted.
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