Systemic lupus erythematosus with chronic persistent intracranial hypertension: A case report
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Published on: February 8, 2022
Minchao Zou1, Xinyu Jiang2, Haifeng Chen1
1Department of Rheumatology and Immunology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.
Insights
Systemic lupus erythematosus (SLE) can cause intracranial hypertension (IH), a rare condition often presenting with headaches. One patient showed chronic IH unresponsive to standard treatments, highlighting a unique clinical course.
Area of Science:
- Neurology
- Rheumatology
- Internal Medicine
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease.
- Intracranial hypertension (IH) is a rare but serious complication of SLE.
- The clinical presentation and management of IH in SLE patients require further investigation.
Objective:
The aim is to investigate the clinical characteristics of systemic lupus erythematosus with intracranial hypertension.
Methods:
The clinical characteristics of one case of systemic lupus erythematosus with chronic persistent intracranial hypertension were analyzed, and related literature was reviewed by searching Medline and Wanfang databases.
Results:
Intracranial hypertension in SLE patients may occur at the onset or during the course of the disease. Our patient was diagnosed with IH 3 years after the onset of SLE. Headache and papilledema were the most common symptoms of intracranial hypertension, followed by nausea or vomiting, vision changes, and cerebral palsy. Our patient had a headache and cranial hypertension that lasted for years, but no papilledema was found. Corticosteroid is currently the mainstay of the treatment of IIH in patients with SLE, and immunosuppressive agents, acetazolamide, intravenous mannitol and furosemide are also used. However, our patient did not respond to these treatments and presents the characteristics of chronic persistent intracranial hypertension.
Conclusion:
Systemic lupus erythematosus with intracranial hypertension is a rare manifestation of SLE, which is not completely parallel to SLE activity. Headache and papilledema were the most common presenting symptoms. Different from previous reported cases, our patient had poor response to treatments, showing chronic and persistent characteristics.
