[Cerebral venous thrombosis as the presenting symptom of systemic lupus erythematosus]. / Trombosis venosa cerebral como presentación de lupus eritematoso sistémico.

INTRODUCTION: Cerebral venous thrombosis (CVT) is an infrequent process in systemic lupus erythematosus. We report the case of a female patient whose initial manifestation of lupus was a CVT. CASE REPORT: A 30-year-old female who presented headaches and diminished visual acuity; on exploring the patient bilateral papilloedema was found. Magnetic resonance imaging revealed the presence of a venous thrombosis in the superior and transversal longitudinal sinus. Complementary explorations showed high levels of antinuclear antibodies with leukopenia and proteinuria. Antiphospholipid antibodies were negative. Following treatment with anticoagulants, the patient's condition improved both clinically and radiologically. Months later a biopsy was performed and revealed a grade IV diffuse glomerulonephritis. CONCLUSIONS: In systemic lupus erythematosus, phenomena such as CVT can be the initial form of presentation of the disease. The presence of antiphospholipid antibodies plays a partial role in CVT; other phenomena, such as inflammatory processes, should also be taken into account.

Trombosis venosa cerebral como presentación de lupus eritematoso sistémico / Cerebral venous thrombosis as the presenting symptom of systemic lupus erythematosus

Introduction. Cerebral venous thrombosis (CVT) is an infrequent process in systemic lupus erythematosus. We report the case of a female patient whose initial manifestation of lupus was a CVT. Case report. A 30-year-old female who presented headaches and diminished visual acuity; on exploring the patient bilateral papilloedema was found. Magnetic resonance imaging revealed the presence of a venous thrombosis in the superior and transversal longitudinal sinus. Complementary explorations showed high levels of antinuclear antibodies with leukopenia and proteinuria. Antiphospholipid antibodies were negative. Following treatment with anticoagulants, the patient’s condition improved both clinically and radiologically. Months later a biopsy was performed and revealed a grade IV diffuse glomerulonephritis. Conclusions. In systemic lupus erythematosus, phenomena such as CVT can be the initial form of presentation of the disease. The presence of antiphospholipid antibodies plays a partial role in CVT; other phenomena, such as inflammatory processes, should also be taken into account (AU)

Introducción. La trombosis venosa cerebral (TVC) no es un proceso habitual en el lupus eritematosos sistémico. Presentamos una paciente cuya manifestación inicial del lupus fue una TVC. Caso clínico. Paciente de 30 años de edad que presenta cefalea y disminución de la agudeza visual; en la exploración destaca un papiledema bilateral. La resonancia magnética realizada demuestra la presencia de una trombosis venosa en el seno longitudinal superior y transverso. Las exploraciones complementarias mostraron altas concentraciones de anticuerpos antinucleares con leucopenia y proteinuria. Los anticuerpos antifosfolípidos fueron negativos. Tras un tratamiento anticoagulante, mejoró clínica y radiológicamente. Meses más tarde se realizó una biopsia, que demostró una glomerulonefritis difusa grado IV. Conclusión. En el lupus eritematoso sistémico, fenómenos como la TVC pueden ser la forma de manifestación inicial de la enfermedad. La presencia de anticuerpos antifosfolípidos participa de forma parcial en la TVC; deberían considerarse otros fenómenos, como los inflamatorios (AU)