J Korean Med Sci.  2001 Jun;16(3):351-354. 10.3346/jkms.2001.16.3.351.

Systemic lupus erythematosus complicated with cerebral venous sinus thrombosis: a report of two cases

• Lee MK
• Kim JH
• Kang HR
• Rho HJ
• Nam EJ
• Kim SW
• Kang YM
• Lee JM
• Kim NS

• KMID: 1129910
• DOI: http://doi.org/10.3346/jkms.2001.16.3.351

Abstract

A rare manifestation of systemic lupus erythematosus (SLE) is cerebral venous sinus thrombosis (CVST), in which early diagnosis and aggressive therapy are of prime importance for favorable outcome. The pathogenesis of CVST is largely unknown, but it is thought to be caused by cerebral vasculitis, antiphospholipid antibodies or other conditions associated with enhanced coagulability. We describe two cases of SLE with CVST which were not associated with antiphospholipid antibodies. Both cases were treated with immunosuppressants (intravenous methylprednisolone and cyclophosphamide pulse therapy) and anticoagulant drugs (heparin and subsequent maintenance therapy with warfarin). There was a marked improvement of neurologic symptoms with the disappearance of thrombus in a follow-up MRI. The possibility of CVST should be considered in any patients with SLE who show neuropsychiatric manifestations.

Keyword

Systemic Lupus Erythematosus; Sinus Thrombosis, Intracranial

MeSH Terms

Adult
Anti-Inflammatory Agents, Steroidal/therapeutic use
Anticoagulants/therapeutic use
Brain/radiography
Cyclophosphamide/therapeutic use
Female
Glucocorticoids, Synthetic/therapeutic use
Heparin/therapeutic use
Human
Immunosuppressive Agents/therapeutic use
Lupus Erythematosus, Systemic/*complications
Magnetic Resonance Imaging
Methylprednisolone/therapeutic use
Middle Age
Sinus Thrombosis, Intracranial/*complications/drug therapy/physiopathology/radiography
Treatment Outcome
Warfarin/therapeutic use