Neuropsychiatric Lupus Diagnosed by Brain PET: A Case Report / 대한류마티스학회지

ABSTRACT

Neuropsychiatric lupus is a complication of systemic lupus erythematosus (SLE) characterized by profound metabolic alteration including impaired blood flow, ischemia, decreased aerobic metabolism and progressive neuronal loss of central nervous system. Because of the lack of useful diagnostic methods, it's diagnosis and management is difficult. Recently, F-18- fluoro-2-deoxy-D-glucose positron emission tomography (18FDG-PET) is considered to be a sensitive and reliable method for evaluating SLE patients with neuropsychiatric involvement as compared with brain computed tomography (CT) or magnetic resornance imaging (MRI). In SLE patient having mild or severe neuropsychiatric manifestations, 18FDG-PET shows hypo- or hypermetabolism by different glucose utilization in brain tissue. We experienced a 23-year-old woman with SLE who presented with seizure and loss of consciousness. Initially, brain MRI finding was negative, but brain 18FDG-PET revealed significant hypometabolism in the cerebral hemisphere at active stage of disease and complete resolution of metabolic abnormalities after treatment. Herein, we report a case of neuropsychiatric lupus diagnosed by brain 18FDG-PET.