ABSTRACT
Neuropsychiatric systemic lupus erythematosus (NPSLE) presents a diagnostic challenge as there is no unified pathophysiological process driving its presentation. Case reports are limited in detailing manifestations and outcomes of NPSLE. This case highlights a unique presentation of NPSLE and discusses challenges associated with diagnosis. A 27-year-old man with systemic lupus erythematosus presented with altered mentation. Initial laboratory results and computed tomography of the brain were unremarkable, but magnetic resonance imaging of the brain revealed ring-enhancing lesions reported as NCC. This led to an extensive infectious disease evaluation, but ultimately there was no evidence of infection. The patient was diagnosed with NPSLE; treatment with intravenous glucocorticoids and cyclophosphamide led to dramatic clinical improvement. Repeat brain magnetic resonance imaging showed resolution of the ringed lesions. This case illustrates the importance of thorough evaluation in immunocompromised patients and warns of the risk of anchoring bias that can lead to diagnostic delays.
Subject(s)
Brain , Cyclophosphamide/administration & dosage , Glucocorticoids/administration & dosage , Lupus Vasculitis, Central Nervous System , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Adult , Brain/diagnostic imaging , Brain/physiopathology , Humans , Lupus Vasculitis, Central Nervous System/diagnosis , Lupus Vasculitis, Central Nervous System/drug therapy , Lupus Vasculitis, Central Nervous System/physiopathology , MaleABSTRACT
BACKGROUND: A health science educational outreach program which began in 1991 and targets K-12 teachers and students has had 15,911 participants consume 60,069 hours of education as of the end of December 2003. The program is called the "Partners in Health Sciences" (PIHS) program. Many educational activities in the PIHS program contain information on both cancer biology and cancer prevention. METHODS: All of the cancer-related education offered and consumed in the history of the PIHS program was identified and quantified. RESULTS: In the PIHS program 984 K-12 teachers and 2,376 grade 7-12 students consumed 4,477 and 3,029 hours of cancer-related education, respectively. CONCLUSIONS: Cancer education encompasses much more than cancer prevention education and includes different aspects of cancer biology from the cell to the organism levels of biological organization. Selected topics in cancer biology can be used to motivate K-12 teachers and students to learn more about basic normal biology while simultaneously learning about cancer. In addition, the psychosocial impact of cancer on the individual, the family, and the community can be used to foster K-12 student interest in studying behavioral science.
