Marked cerebrospinal fluid pleocytosis in systemic lupus erythematosus related cerebral ischemia.

Pleocytosis of the cerebrospinal fluid (CSF) may accompany central nervous system lesions that occur as a result of systemic lupus erythematosus (SLE); however, the number of CSF white blood cells is usually less than 50/mm3 and the predominant cell is the lymphocyte. A young woman with SLE had 2 acute episodes of hemorrhagic cerebral ischemia, each of which was associated with a neutrophilic CSF pleocytosis (white blood count 480-2250/mm3). This type of meningeal reaction may have been related to the proximity of the cerebral lesions to the ventricles, a phenomenon previously described in non SLE related cerebral infarcts.