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Tse GG, Santos-Ocampo AS, Chow DC, et al. Diffuse leukoencephalopathy and subacute parkinsonism as an early manifestation of systemic lupus erythematosus. Case Rep Neurol Med. 2013;2013:367185doi: 10.1155/2013/367185.
Tse, G. G., Santos-Ocampo, A. S., Chow, D. C., McMurtray, A. M., & Nakamoto, B. K. (2013). Diffuse leukoencephalopathy and subacute parkinsonism as an early manifestation of systemic lupus erythematosus. Case reports in neurological medicine, 2013367185. https://doi.org/10.1155/2013/367185
Tse, Gary G, et al. "Diffuse leukoencephalopathy and subacute parkinsonism as an early manifestation of systemic lupus erythematosus." Case reports in neurological medicine vol. 2013 (2013): 367185. doi: https://doi.org/10.1155/2013/367185
Tse GG, Santos-Ocampo AS, Chow DC, McMurtray AM, Nakamoto BK. Diffuse leukoencephalopathy and subacute parkinsonism as an early manifestation of systemic lupus erythematosus. Case Rep Neurol Med. 2013;2013:367185. doi: 10.1155/2013/367185. Epub 2013 Nov 28. PMID: 24369514; PMCID: PMC3863508.
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Case Rep Neurol Med. 2013;2013:367185. doi: 10.1155/2013/367185. Epub 2013 Nov 28.

Diffuse leukoencephalopathy and subacute parkinsonism as an early manifestation of systemic lupus erythematosus.

Case reports in neurological medicine

Gary G Tse, Alberto S Santos-Ocampo, Dominic C Chow, Aaron M McMurtray, Beau K Nakamoto

Affiliations

  1. Department of Medicine, University of Hawaii, Honolulu, HI 96813, USA.
  2. Straub Clinics and Hospital, Honolulu, HI 96813, USA.
  3. Department of Neurology, Harbor-UCLA Medical Center, Torrance, CA 90502, USA.
  4. Department of Medicine, University of Hawaii, Honolulu, HI 96813, USA ; Straub Clinics and Hospital, Honolulu, HI 96813, USA.

PMID: 24369514 PMCID: PMC3863508 DOI: 10.1155/2013/367185

Abstract

Parkinsonism in SLE is rare. Diffuse leukoencephalopathy is equally uncommon and is associated with a poor prognosis. We present a single case of a 50-year-old Filipino man who presented with a generalized discoid rash after starting lisinopril. The rash persisted despite discontinuation of lisinopril, and over the next three months, he developed rapidly progressive parkinsonism. Brain MRI showed symmetric confluent T2-hyperintensities involving the white matter and basal ganglia. Four of the 11 American College of Rheumatology criteria for the classification of SLE were met. A rheumatologist made a diagnosis of SLE with cutaneous and central nervous system involvement. Significant neurologic and radiologic improvement occurred following treatment with IV steroids followed by a prolonged taper. This report highlights a case of subacute parkinsonism with a diffuse leukoencephalopathy as an early manifestation of SLE which resulted in a good recovery following treatment with only immunosuppressive therapy.

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