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

Intern Med. 2018 Oct 15;57(20):3025-3028. doi: 10.2169/internalmedicine.0934-18. Epub 2018 May 18.

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.

Keywords: cognitive dysfunction; immunosuppressive therapy; systemic lupus erythematosus.

Publication types

  • Case Reports

MeSH terms

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

Substances

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