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AJNR Am J Neuroradiol ; 39(12): 2263-2269, 2018 12.
Article in English | MEDLINE | ID: mdl-30467216

ABSTRACT

Systemic lupus erythematosus is a chronic autoimmune disease characterized by the production of autoantibodies resulting in tissue injury across multiple organs; up to 50% of patients develop neurologic involvement, collectively referred to as neuropsychiatric systemic lupus erythematosus. The cases in this clinical report will highlight a subtype of neuropsychiatric systemic lupus erythematosus demonstrating imaging findings of striatal inflammation responsive to plasmapheresis similar to those in the subset of N-methyl-D-aspartate receptor autoimmune encephalitis that involves the striatum. Although the cause for this striking imaging appearance is not definitely known, literature will be presented supporting the hypothesis that it is due to peripheral anti-double-stranded DNA antibodies entering the central nervous system to cross-react with N-methyl-D-aspartate receptor antigens.


Subject(s)
Corpus Striatum/immunology , Encephalitis/immunology , Encephalitis/pathology , Lupus Vasculitis, Central Nervous System/immunology , Lupus Vasculitis, Central Nervous System/pathology , Adult , Aged , Antibodies, Antinuclear/immunology , Autoantibodies/immunology , Corpus Striatum/diagnostic imaging , Corpus Striatum/pathology , Cross Reactions , Encephalitis/therapy , Female , Humans , Lupus Vasculitis, Central Nervous System/therapy , Male , Plasmapheresis , Receptors, N-Methyl-D-Aspartate/immunology , Young Adult
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