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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.

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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.