A Case of SLE Presenting Stroke-Like Symptoms

• Published in: Internal Medicine Vol. 50; no. 4; pp. 359 - 362
• Main Authors: Ishitsuka, Koji, Ago, Tetsuro, Fukuda, Kenji, Fukushima, Yoshihisa, Gotoh, Seiji, Yubi, Tomohiro, Kamouchi, Masahiro, Kitazono, Takanari
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2011
• Subjects: Cerebrovascular Circulation; Diagnosis, Differential; Female; Humans; Lupus Erythematosus, Systemic - diagnosis; Lupus Erythematosus, Systemic - diagnostic imaging; Lupus Erythematosus, Systemic - physiopathology; Lupus Vasculitis, Central Nervous System - diagnosis; Lupus Vasculitis, Central Nervous System - diagnostic imaging; Lupus Vasculitis, Central Nervous System - physiopathology; Magnetic Resonance Imaging; Middle Aged; MRI; NPSLE; SLE; small vessel vasculopathy; SPECT; stroke; Stroke - diagnosis; Stroke - diagnostic imaging; Stroke - physiopathology; Tomography, Emission-Computed, Single-Photon
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.50.4548

We report a 50-year-old woman with systemic lupus erythematosus (SLE) who developed stroke-like symptoms, including disturbance of consciousness and severe left hemiparesis. Despite the stroke-like symptoms, MR imaging showed quite atypical findings for stroke; broad high-intensity areas in the right fronto-parietal lobes on diffusion-weighted images were shown mainly as iso-intensity areas on the ADC map, without any findings of stenosis of the cerebral large arteries. The cerebral blood flow in these areas was significantly decreased, as evaluated by single photon emission computed tomography. The present case suggests that small vessel vasculopathies localized in the unilateral hemisphere could cause "stroke-like" symptoms in SLE.