Central Nervous System Systemic Lupus Erythematosus (CNS-SLE) Vasculitis Mimicking Lewy Body Dementia: A Case Report Emphasizing the Role of Imaging With an Analysis of 33 Comparable Cases From the Scientific Literature.
| Autor: | Abraham P; Department of Psychiatry, 8784University of California, San Diego, CA, USA., Neel I; Department of Internal Medicine, 8784University of California, San Diego, CA, USA., Bishay S; 8790University of California, Riverside, CA, USA., Sewell DD; Department of Psychiatry, 8784University of California, San Diego, CA, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of geriatric psychiatry and neurology [J Geriatr Psychiatry Neurol] 2021 Mar; Vol. 34 (2), pp. 128-141. Date of Electronic Publication: 2020 Jan 30. |
| DOI: | 10.1177/0891988720901788 |
| Abstrakt: | Introduction: Neuropsychiatric symptoms occur in 30% to 40% of patients living with systemic lupus erythematosus (SLE). Brain imaging may play a pivotal role in determining the etiology as it did for the case presented here. Methods: A new case of central nervous system (CNS) SLE is presented along with an analysis of 33 comparable cases from the scientific literature. Results: A 70-year-old female with subacute cutaneous lupus presented to a university-based geropsychiatry program after 1 year of benign visual hallucinations and several months of shuffling gait, recurrent falls, and forgetfulness. These symptoms were highly suggestive of Lewy body dementia; however, the patient's history of basal ganglia infarct, cognitive testing demonstrating inattention and executive dysfunction, and follow-up brain imaging, which did not reveal acute findings, aligned with cerebral pathology previously attributed to vasculitis and supported the diagnosis of subcortical dementia due to SLE-CNS vasculitis. Oral prednisone 20 mg daily resolved her symptoms. Over the next 19 months, her prednisone was tapered completely and her symptoms did not return. A systematic literature search identified 33 comparable cases. Conclusion: An analysis of previously published cases suggests that extending the duration of the prednisone taper beyond 1 year may decrease the risk of later occurring neuropsychiatric symptoms in this patient population. |
| Databáze: | MEDLINE |
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