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11 April 2024 : Case report  China (mainland)

[In Press] Uncommon Presentation of Systemic Lupus Erythematosus: Intracranial Mass Lesions as the First Manifestation

Mistake in diagnosis, Unusual setting of medical care, Patient complains / malpractice, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Nannan Dong1ABCDE, Mengqi Niu1ABCDE, Xialing Wang1CDE, Zhenzheng Bai1ACE, Si Tian1CDE, Kebin Zeng1DFG

DOI: 10.12659/AJCR.942877

Am J Case Rep In Press; DOI: 10.12659/AJCR.942877  

Available online: 2024-04-11, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule

Abstract

BACKGROUND
Multi-system damage is a hallmark of systemic lupus erythematosus (SLE), a chronic systemic autoimmune disease. The typical initial symptoms of SLE are arthritis and dermatosis, whereas the presence of intracranial mass lesions as the first manifestation of systemic lupus erythematosus is very rare. This report describes an 18-year-old woman with intracranial mass lesions associated with SLE.
CASE REPORT
An 18-year-old woman was initially admitted to the hospital because of headache for 3 days, weakness in left arm, and blurred vision for 1 day. Magnetic resonance imaging (MRI) of her brain showed multiple abnormal occupying lesions in the right frontoparietal lobe. However, no evidence of tumor or infection was found. One month later, she was readmitted with right limb weakness and aphasia for 1 day. Brain MRI showed obvious and new abnormal signal shadows in both the right parietal lobe and the left frontotemporal parieto-occipital lobes compared with the previous MRI. She responded positively to immunotherapy, which, in a woman of child-bearing age, supports the diagnosis of SLE. Ultimately, the presence of focal neurological symptoms, abnormal autoantibodies (such as antinuclear antibodies, anti-dsDNA antibodies, anti-SSA autoantibodies, and anti-ribosomal P protein antibodies), as well as her positive response to immunotherapy, contributed to the diagnosis of SLE with intracranial mass lesions. No recurrence was seen during 1 year of follow-up.
CONCLUSIONS
It is unusual for SLE to present with intracranial mass lesions as the initial symptoms. The pathogenesis of the neurological symptoms of the patient may be small vessel thrombosis or vasculitis leading to cerebral mass-like necrosis.

Keywords: Lupus Vasculitis, Central Nervous System; Intracranial Thrombosis; Clinical Medicine; Magnetic Resonance Imaging

In Press

Case report  Iran

Simultaneous L1-2 Bulged Disc and Mobile Spinal Schwannoma Causing Cauda Equina Syndrome: A Rare Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.942717  

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Case report  Thailand

Severe Complications of Uterine Dehiscence Post-Lower Segment Cesarean Section: A Case Report Emphasizing t...

Am J Case Rep In Press; DOI: 10.12659/AJCR.943027  

Case report  USA

A Prefixed Four-Trunk Brachial Plexus with Anomalous Anatomy of All Subsequent Divisions, Cords, and Termin...

Am J Case Rep In Press; DOI: 10.12659/AJCR.943866  

Case report  USA

Rapid Progression of Malignant Peritoneal Mesothelioma Mimicking a Postoperative Complication in a Young Wo...

Am J Case Rep In Press; DOI: 10.12659/AJCR.942948  

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923