Intracranial hypertension as the first manifestation of systemic lupus erythematosus: A case report

Abstract

Introduction: 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. Case report: 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. Conclusion: 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.

Keywords

• Intracranial hypertension
• Papilledema
• Lupus nephritis
• Systemic lupus erythematosus
• Case reports