Reversible Cognitive Dysfunction in Elderly-onset Systemic Lupus Erythematosus, Successfully Treated with Aggressive Immunosuppressive Therapy.

Abstract

A 70-year-old Japanese woman presented to our hospital with gait disturbance and cognitive dysfunction. Since she had arthritis, lymphopenia, hypocomplementemia, and anti-nuclear and anti-double-stranded DNA antibodies, she was diagnosed with systemic lupus erythematosus (SLE). T2-weighted magnetic resonance imaging revealed bilateral hyperintensities in the putamen. Based on her cognitive impairment, muscle rigidity, and high levels of interleukin-6 in the cerebrospinal fluid, we believed she had developed a complication of a neuropsychiatric disease and administered corticosteroids and intravenous cyclophosphamide therapy. Her cognitive function fully recovered, and her gait disturbance improved. Attending to cognitive impairment in elderly SLE patients is necessary.

• Authors: Yuya Fujita, Shoichi Fukui, Midori Ishida, Yushiro Endo, Sosuke Tsuji, Ayuko Takatani, Takashi Igawa, Toshimasa Shimizu, Masataka Umeda, Remi Sumiyoshi, Ayako Nishino, Tomohiro Koga, Shin-Ya Kawashiri, Naoki Iwamoto, Kunihiro Ichinose, Mami Tamai, Hideki Nakamura, Tomoki Origuchi, Atsushi Kawakami
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 57 Issue 20 Pg. 3025-3028 (Oct 15 2018) ISSN: 1349-7235 [Electronic] Japan
• PMID: 29780145 (Publication Type: Case Reports, Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Antibodies, Antinuclear
• Immunosuppressive Agents
• Cyclophosphamide

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Aged
• Antibodies, Antinuclear (therapeutic use)
• Asian People
• Cognitive Dysfunction (drug therapy, etiology)
• Cyclophosphamide (therapeutic use)
• Female
• Humans
• Immunosuppression Therapy (methods)
• Immunosuppressive Agents (therapeutic use)
• Lupus Erythematosus, Systemic (complications)
• Magnetic Resonance Imaging
• Treatment Outcome