Ring-enhancing demyelinating lesions in the brain and optic neuritis: Atypical presentation of paediatric neuropsychiatric SLE
Document Type
Case Report
Department
Paediatrics and Child Health; Medical College Pakistan; Biological and Biomedical Sciences
Abstract
Paediatric-onset systemic lupus erythematosus (SLE) is a rare but clinically significant condition, often presenting with central nervous system (CNS) involvement. The most common CNS manifestations include headaches, seizures and psychosis. We present two cases of neuropsychiatric SLE with unusual clinical and imaging features.The first case involves an adolescent girl who presented with unilateral vision loss and elevated intracranial pressure. MRI revealed large well-defined ring-enhancing lesions in the bilateral subcortical white matter. She underwent extensive evaluation for infectious, autoimmune and demyelinating causes.The second case concerns another adolescent girl who presented with bilateral vision loss, with MRI showing small ring-enhancing lesions in the brain. Both patients had initially been treated for CNS tuberculosis with anti-tuberculous therapy before being referred to our hospital.In both cases, the diagnosis of SLE was confirmed by elevated anti-double-stranded DNA antibody levels. Both patients responded favourably to immunotherapy. These cases add to the existing literature by describing unique manifestations of neuropsychiatric SLE in children and emphasising the importance of early diagnosis and timely intervention to improve outcomes.
Publication (Name of Journal)
BMJ Case Rep
DOI
10.1136/bcr-2025-270349
Recommended Citation
Raza, M.,
Jaskani, H.,
Jaskani, M.
(2026). Ring-enhancing demyelinating lesions in the brain and optic neuritis: Atypical presentation of paediatric neuropsychiatric SLE. BMJ Case Rep, 19(6), 1-7.
Available at:
https://ecommons.aku.edu/pakistan_fhs_mc_women_childhealth_paediatr/1726