A Case of 45-year-old female with systemic lupus erthematosus presenting as central nervous system vasculitis / Edelweise G. Merin.

Includes appendices and bibliographical references.

ABSTRACT: Vasculitis may involve the nervous system (CNS), including Bechey`s disease, polyarteritis nodosa, vasculitis associated with connective tissue disease such as lupus (systemic lupus erythematous; SLE), No other forms of vasculitis is as difficult to diagnose as CNS vasculitis. We are presenting a 45- year-old female who had headache, vomiting and sudden loss of consciousness. Pertinent physical examination revealed patchy blind spots in visual fields, Bipedal pitting edema and Raynaud`s phenomenon and arthritis were noted. Can read simple words but with difficulty in writing due to weakness. Diffusion weighted MRI (BRAIN) done revealed markedly FLAIR - hyperintense (subtley hyperitense of T2 - diffusion and T2W images) cortical lesions in occipital and right parietal lobes. EEG done showed slowing of electrical impulses on the bifrontal areas which tends to be more ectensive as compared to the MRI result. Initial CSF findings showed leukocytosis with predominance of segmenters, CSF IgG was elevated, ANA titer and CRP positive are all suggestive of vasculitic syndrome. Anti -ds DNA was positive which confirmed the diagnosis of SLE as the cause of the CNS vasculitis. The primary treatment to vasculitis is immunosuppressive therapy, patient was started with Methylprednisolone. Patient was followed up closely and gradually improved without neurologic dificits.

Research - Department of Medicine