[Reversible changes of cranial MRI in a girl with SLE]

The 11-year-old girl had hypertension and generalized tonic-clonic convulsions during the steroid pulse therapy. Her cranial T2-weighed MRI showed small areas of high signal intensity in the right occipital lobe. Her neurological findings were normal. After 2 months of steroid pulse therapy, multiple high signal intensities were demonstrated on T2-weighed MRI. After 5 months of the therapy, however, only a small T2-weighed MRI spot of high signal intensity in the white matter was observed, and the multiple lesions disappeared. On follow up, she did not show any neurological defects. It is postulated that not only steroid pulse therapy-induced hypertension but also SLE-induced angiopathy caused such flexible lesions. According to the literature, these lesions can be considered to be edema around small vessels. Such MRI findings have been reported in adult patients with SLE, but to our knowledge there have not been reports on children with SLE.