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- Title
Diffuse Leukoencephalopathy and Subacute Parkinsonism as an Early Manifestation of Systemic Lupus Erythematosus.
- Authors
Tse, Gary G.; Santos-Ocampo, Alberto S.; Chow, Dominic C.; McMurtray, Aaron M.; Nakamoto, Beau K.
- Abstract
Parkinsonism in SLE is rare. Diffuse leukoencephalopathy is equally uncommon and is associatedwith a poor prognosis. We present a single case of a 50-year-old Filipinoman who presented with a generalized discoid rash after starting lisinopril. The rash persisted despite discontinuation of lisinopril, and over the next three months, he developed rapidly progressive parkinsonism. Brain MRI showed symmetric confluent T2-hyperintensities involving the white matter and basal ganglia. Four of the 11 American College of Rheumatology criteria for the classification of SLE were met. A rheumatologistmade a diagnosis of SLE with cutaneous and central nervous system involvement. Significant neurologic and radiologic improvement occurred following treatment with IV steroids followed by a prolonged taper. This report highlights a case of subacute parkinsonism with a diffuse leukoencephalopathy as an early manifestation of SLE which resulted in a good recovery following treatment with only immunosuppressive therapy.
- Subjects
SYSTEMIC lupus erythematosus; PROGRESSIVE multifocal leukoencephalopathy; SUBACUTE care; PARKINSONIAN disorders; RARE diseases; MAGNETIC resonance imaging of the brain; IMMUNOSUPPRESSIVE agents; PROGNOSIS
- Publication
Case Reports in Neurological Medicine, 2013, p1
- ISSN
2090-6668
- Publication type
Article
- DOI
10.1155/2013/367185