A case of systemic lupus erythematosus associated with cerebral arteritis: a case report and case-based literature review

Nagoya J Med Sci. 2020 Nov;82(4):807-814. doi: 10.18999/nagjms.82.4.807.

Abstract

A 62-year-old female patient with systemic lupus erythematosus (SLE) was admitted for cerebral infarction. The magnetic resonance angiography showed focal narrowing of the cerebral arteries that was initially considered as atherosclerosis due to her cardiovascular risk factors. Ten weeks later, she was again admitted for multiple cerebral infarctions. Vessel wall magnetic resonance imaging revealed gadolinium enhancement of the arterial walls of the narrowing lesions, leading to a diagnosis of cerebral arteritis. Based on a literature review, cerebral medium-sized arteritis in SLE likely progresses insidiously during the active phase of SLE, which may later result in occlusion irrespective of disease activity.

Keywords: central nervous system vasculitis; cerebral arteritis; cerebral medium-sized arteritis; systemic lupus erythematosus; vessel wall MRI.

Publication types

  • Case Reports

MeSH terms

  • Antirheumatic Agents / therapeutic use
  • Arteritis* / diagnostic imaging
  • Arteritis* / etiology
  • Cerebral Infarction* / diagnosis
  • Cerebral Infarction* / etiology
  • Cerebral Infarction* / physiopathology
  • Cerebral Infarction* / therapy
  • Cyclophosphamide / therapeutic use*
  • Diffusion Magnetic Resonance Imaging / methods
  • Disease Progression
  • Female
  • Humans
  • Lupus Erythematosus, Systemic* / complications
  • Lupus Erythematosus, Systemic* / diagnosis
  • Lupus Erythematosus, Systemic* / therapy
  • Lupus Vasculitis, Central Nervous System* / complications
  • Lupus Vasculitis, Central Nervous System* / diagnosis
  • Magnetic Resonance Angiography / methods*
  • Middle Aged
  • Paresis* / diagnosis
  • Paresis* / etiology
  • Paresis* / therapy
  • Patient Acuity
  • Prognosis
  • Recurrence

Substances

  • Antirheumatic Agents
  • Cyclophosphamide