Systemic Lupus Erythematosus and Third Nerve Palsy: Unusual Presentation and Review of the Literature

We report the case of a young female with pyrexia of unknown origin, cutaneous macules and an incomplete third cranial nerve palsy, that led to the diagnosis of systemic lupus erythematosus (SLE) with neurological manifestations. Her visual acuity was normal. Fundus examination showed cotton wool sp...

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Bibliographic Details
Published in:Neuro-ophthalmology (Amsterdam : Aeolus Press. 1980) 2022-03, Vol.46 (2), p.109-114
Main Authors: Natarajan, Divya, Kannam, Mohan, Reddy, M Vishnu Vardhan, Sachdeva, Virender
Format: Article
Language:English
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Case Report
Case Reports
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Summary:We report the case of a young female with pyrexia of unknown origin, cutaneous macules and an incomplete third cranial nerve palsy, that led to the diagnosis of systemic lupus erythematosus (SLE) with neurological manifestations. Her visual acuity was normal. Fundus examination showed cotton wool spots in both eyes. Neuroimaging was also normal. Systemic work up revealed pancytopaenia, hypocomplementaemia, and the presence of multiple autoantibodies including anti-double stranded deoxyribonucleic acid and lupus anticoagulant. She was effectively treated with intravenous pulsed corticosteroid therapy, cyclophosphamide, and oral hydroxychloroquine. This case highlights the uncommon involvement of cranial nerve mononeuropathy in SLE, the importance of systemic examination and autoimmune workup in young patients with such a presentation.
ISSN:0165-8107
1744-506X
DOI:10.1080/01658107.2021.1912113