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MRI changes in the central nervous system in a child with lupus erythematosus
M A Gieron1, S Khoromi, A Campos
1Department of Pediatrics, University of South Florida, College of Medicine, Tampa 33606, USA.
Insights
Systemic lupus erythematosus (SLE) can cause seizures as the sole sign of central nervous system (CNS) involvement in children. Brain MRI revealed widespread lesions that significantly improved with methylprednisolone treatment, mirroring adult findings.
Area of Science:
- Neurology
- Pediatrics
- Rheumatology
Background:
- Systemic lupus erythematosus (SLE) is a complex autoimmune disease with potential neurological complications.
- Central nervous system (CNS) involvement in pediatric SLE can manifest in various ways.
Observation:
- A 10-year-old girl presented with status epilepticus as the only clinical sign of CNS involvement.
- Cerebral magnetic resonance imaging (MRI) demonstrated diffuse white and gray matter lesions.
Findings:
- The observed MRI lesions showed near-complete resolution following treatment with methylprednisolone.
- The pattern of brain lesions in this pediatric case was comparable to that seen in adult patients with diffuse CNS lupus.
Implications:
- This case highlights the importance of considering CNS lupus in the differential diagnosis of new-onset seizures in children.
- Early recognition and prompt treatment, as demonstrated, can lead to significant recovery.
- MRI is a crucial tool for evaluating CNS involvement in pediatric SLE.
Abstract:
We report on a 10-year-old girl with systemic lupus erythematosus who presented in status epilepticus as the only manifestation of central nervous system involvement. MRI of the brain showed diffuse gray and white matter lesions which almost completely resolved after treatment with methylprednisolone. MRI findings in this child are similar to those in adults with diffuse clinical manifestations. The study is essential in the initial evaluation of patients suspected of central nervous system lupus.