Neuropsychiatric Systemic Lupus Erythematosus with Cerebral Vasculitis and Lupus Nephritis Successfully Treated with High-dose Glucocorticoids and Mycophenolate Mofetil

Neuropsychiatric systemic lupus erythematosus (NPSLE) with cerebral vasculitis is rare, and its prognosis is unfavorable. High-dose glucocorticoids and cyclophosphamide are widely used for the treatment of NPSLE, but cyclophosphamide has a risk of cervical intraepithelial neoplasia and ovarian insuf...

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Published in:Internal Medicine 2022/10/15, Vol.61(20), pp.3131-3135
Main Authors: Tanaka, Saki, Kawaguchi, Takeshi, Kudo, Risa, Kimura, Masatoshi, Rikitake, Yuki, Iwao, Chihiro, Rikitake, Mao, Iwao, Kosho, Aizawa, Ayako, Kariya, Yumi, Matsuda, Motohiro, Miyauchi, Shunichi, Takajo, Ichiro, Umekita, Kunihiko
Format: Article
Language:English
Subjects:
cerebral vasculitis
Cervix
Cyclophosphamide
Glucocorticoids
Internal medicine
Lupus nephritis
Mycophenolate mofetil
Mycophenolic acid
Nephritis
Neurological complications
neuropsychiatric systemic lupus erythematosus
Systemic lupus erythematosus
Toxicity
Vasculitis
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Summary:Neuropsychiatric systemic lupus erythematosus (NPSLE) with cerebral vasculitis is rare, and its prognosis is unfavorable. High-dose glucocorticoids and cyclophosphamide are widely used for the treatment of NPSLE, but cyclophosphamide has a risk of cervical intraepithelial neoplasia and ovarian insufficiency, which may discourage its use in young women. We experienced a case of NPSLE with cerebral vasculitis and lupus nephritis that responded successfully to glucocorticoids and mycophenolate mofetil (MMF). MMF might be a treatment option for NPSLE without concern for reproductive toxicity. However, there are only a few reports on the efficacy of MMF in NPSLE, and further investigations are needed.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.9123-21