[Central nervous system involvement in systemic lupus erythematosus]

Area of Science:

• Neurology
• Rheumatology
• Immunology

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with potential multi-organ involvement.
• Central nervous system (CNS) manifestations in SLE can be diverse and challenging to diagnose.
• Accurate diagnosis relies on clinical presentation, serological markers, and sometimes biopsy confirmation.

Observation:

• Case 1: A 16-year-old presented with chorea and psychosis, later diagnosed with SLE-related CNS lesions and renal involvement.
• Case 2: A 24-year-old developed hemiparesis, coma, and progressive dementia, diagnosed with SLE despite negative autoantibodies.
• Case 3: A 47-year-old experienced chronic arthralgia, uveitis, and recurrent neurological deficits over many years, suggestive of SLE.

Findings:

• CNS lesions were key indicators of SLE in two of the three presented cases.
• Neurological symptoms ranged from movement disorders and psychosis to stroke-like deficits and dementia.
• Diagnosis of SLE was confirmed by ARA criteria and renal biopsy, even with atypical serological findings.

Implications:

• Recognizing diverse CNS presentations is vital for early SLE diagnosis.
• SLE should be considered in patients with unexplained neurological and psychiatric disorders.
• Timely intervention may improve outcomes for SLE patients with CNS involvement.