Systemic lupus erythematosus presenting as optic neuritis.

A 57-year-old white man presented with unilateral optic neuritis. General physical examination and neurologic consultation revealed no further findings. Laboratory investigation, however, yielded an elevated sedimentation rate, positive LE preparation, elevated ANA titer, false-positive VDRL, and red blood cell casts in the urine. A diagnosis of systemic lupus erythematosus (SLE) was made. The patient was treated with sub-Tenon and systemic corticosteroids. There was a moderate improvement in central visual acuity. The suspected pathophysiology of SLE is reviewed. The papillitis presumably reflects the generalized vasculitis of SLE and may be responsive to corticosteroids as are other signs and symptoms of this disease.