Pugliese Isabella, Posada María, Shinchi Masaru, Aguirre-Valencia David
Universidad Icesi, Facultad de Ciencias de la Salud, Calle 18 No. 122 -135, Cali, Colombia.
Fundación Valle del Lili, Unidad de Neurología, Cra 98 No. 18 - 49, Cali, 760032, Colombia.
Heliyon. 2024 Oct 5;10(20):e38880. doi: 10.1016/j.heliyon.2024.e38880. eCollection 2024 Oct 30.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple systems and organs, including the central and peripheral nervous systems. Papilledema and idiopathic intracranial hypertension, in the absence of space-occupying lesions or other detectable causes, is a rare manifestation. We report the case of a young woman with chronic headache, papilledema, and intracranial hypertension on examination, in whom a de novo diagnosis of systemic lupus erythematosus and class V lupus nephritis was made. It is important to recognize this association when the review of systems supports it.
A 19-year-old Colombian woman with recent hypothyroidism presented with a chronic severe headache and was found to have papilledema. She reported several systemic symptoms including hair loss, skin dryness, and edema. Brain MRI and lumbar puncture were conducted, with high opening pressure noted but no significant abnormalities. She was diagnosed with Systemic Lupus Erythematosus (SLE) based on symptoms and positive autoimmune markers. Treatment with methylprednisolone and other medications led to an improvement in her symptoms, and a renal biopsy confirmed lupus nephritis class V. The comprehensive treatment regime effectively managed her symptoms.
In the case of papilledema with idiopathic intracranial hypertension, always carry out an in-depth review by systems to rule out SLE as a cause.
系统性红斑狼疮（SLE）是一种慢性自身免疫性疾病，可累及多个系统和器官，包括中枢和周围神经系统。在没有占位性病变或其他可检测到的病因的情况下，视乳头水肿和特发性颅内高压是一种罕见的表现。我们报告了一例年轻女性病例，该患者检查时出现慢性头痛、视乳头水肿和颅内高压，最终确诊为新发系统性红斑狼疮和Ⅴ型狼疮性肾炎。当系统回顾支持这种关联时，认识到这种关联很重要。
一名19岁的哥伦比亚女性，近期患有甲状腺功能减退症，出现慢性严重头痛，检查发现视乳头水肿。她报告了包括脱发、皮肤干燥和水肿在内的几种全身症状。进行了脑部MRI和腰椎穿刺，发现初压高，但无明显异常。根据症状和自身免疫标志物阳性，她被诊断为系统性红斑狼疮（SLE）。使用甲基强的松龙和其他药物治疗后，她的症状有所改善，肾活检证实为Ⅴ型狼疮性肾炎。综合治疗方案有效地控制了她的症状。
对于伴有特发性颅内高压的视乳头水肿病例，始终要通过系统进行深入回顾，以排除SLE作为病因。
