Central Nervous System (CNS) Vasculitis in a Patient with Systemic Lupus Erythematosus (SLE) and Lupus Nephritis: A Case Report

Background: Systemic lupus erythematosus (SLE) is characterized by diverse symptoms including fever, joint pain, facial rash, blood in urine, and sores in the mouth. Neuropsychiatric SLE (NPSLE) refers to neurological and psychiatric manifestations in SLE patients after exclusion of other potential causes. Case Presentation: A 21-year-old woman with established lupus nephritis presented with left-sided weakness, aphasia, confusion and focal neurological deficits. Imaging studies demonstrated multiple infarcts and central nervous system (CNS) vasculitis. Treatment with intravenous methylprednisolone and antibiotics led to clinical improvement. Discussion: CNS vasculitis is a rare complication of SLE, manifesting as seizures, cognitive impairment, or stroke-like symptoms. MRI and angiographic studies aid in diagnosis, while early treatment with steroids and cyclophosphamide improves prognosis. Prompt immunosuppressive therapy is essential for better patient outcomes. Conclusion: This case highlights the importance of recognizing NPSLE in lupus patients with neurological symptoms and underscores the necessity for timely diagnosis and intervention to mitigate potential morbidity.