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Case 279
Peter Abraham1, Katherine Longardner1, Patrick Chen1
1From the School of Medicine (P.A.), Department of Neurosciences (K.L., P.C., B.H.), and Department of Radiology (J.H.), University of California San Diego Medical Center, 200 West Arbor Dr, San Diego, CA 92103.
Radiology
|February 19, 2020
Summary
A young woman with lupus nephritis experienced a seizure due to severe hyponatremia. Prompt correction of low sodium levels resolved the seizure, highlighting the neurological risks of hyponatremia in lupus patients.
Area of Science:
- Nephrology
- Neurology
- Immunology
Background:
- Systemic lupus erythematosus (SLE) and lupus nephritis can present with diverse neurological complications.
- Hyponatremia is a potential electrolyte disturbance that can precipitate neurological symptoms.
Purpose of the Study:
- To report a case of generalized tonic-clonic seizure in a patient with lupus nephritis.
- To investigate the association between severe hyponatremia and seizure activity in this clinical context.
Main Methods:
- Case report of a 25-year-old woman with class IV lupus nephritis.
- Clinical presentation, laboratory findings (including serum sodium), and treatment course were documented.
- Neurological status and management of electrolyte imbalance were monitored.
Main Results:
- The patient presented with edema and was treated with methylprednisolone, furosemide, and C1 esterase inhibitor.
- A generalized tonic-clonic seizure occurred concurrently with severe hyponatremia (serum sodium 122 mEq/L).
- Correction of hyponatremia over 48 hours led to resolution of symptoms; cerebrospinal fluid and head CT were unremarkable.
Conclusions:
- Severe hyponatremia can be a precipitating factor for seizures in patients with lupus nephritis.
- Careful monitoring and prompt correction of electrolyte imbalances are crucial in managing lupus nephritis patients with neurological symptoms.
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