Meningitis as the initial manifestation of systemic lupus erythematosus

Systemic Lupus Erythematosus (SLE) is an idiopathic chronic autoimmune disease that can affect multiple organs including the Central Nervous System (CNS). CNS involvement is seen in many SLE patients; however, usually it is preceded by/or in conjunction with other organ-system involvement. The spectrum of CNS involvement is wide and includes numerous neuro-psychiatric syndromes but rarely meningitis. Even when meningitis occurs it is almost never the presenting manifestation of SLE. Our case had chronic aseptic meningitis as the initial and seemingly sole manifestation of SLE, which was erroneously, treated as tuberculous (TB) meningitis.