[Intracranial hypertension and lupus]

Rev Neurol (Paris). 2011 Jun-Jul;167(6-7):505-10. doi: 10.1016/j.neurol.2010.10.014. Epub 2011 Mar 21.
[Article in French]

Abstract

Introduction: Idiopathic intracranial hypertension (IH) occurs most commonly in women and overweight subjects. It must be reported associated to general diseases, like systemic lupus erythematosus (SLE).

Methods: We report an observation of a patient with lupus complicated by glomerulonephritis and IH.

Observation: A 29 years old woman, without overweight, was followed for a SLE with skin and arthritic involvement . Four years after onset, a renal complication appeared with severe nephrotic syndrome. Six weeks after, bilateral papillar oedema was discovered, revealing an IH, as the patient was treated by oral steroids at 1mg/kg/d and bimonthly intravenous cyclophosphamide. The patient was completely asymptomatic. Brain MRI with veino-RMN was normal, without cerebral venous thrombosis. Lumbar punction showed an elevated opening pressure of 30,5 cmH(2)0 but with normal cerebrospinal fluid (CSF) contents. Evacuation of 30 mL of CSF and immunosuppressive treatment allowed symptoms regression.

Discussion/conclusion: Twenty-seven cases of IH associated to SLE with nephritis have been reported in literature. Young women are more frequently involved with in half of cases a diffuse proliferative glomerulonephritis. Predisposing factors, like anaemia, must be associated. IH allows SLE diagnose in more than the third of the cases. Then, SLE has to be searched as an etiology of IH, in particular in non-obese patients and when nephritis is associated.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Angiography
  • Cyclophosphamide / therapeutic use
  • Eye / pathology
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Intracranial Hypertension / etiology
  • Intracranial Hypertension / physiopathology*
  • Kidney Papillary Necrosis / pathology
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / physiopathology*
  • Magnetic Resonance Imaging
  • Nephrotic Syndrome / etiology
  • Neurologic Examination
  • Optic Disk / pathology
  • Optic Nerve / pathology

Substances

  • Adrenal Cortex Hormones
  • Immunosuppressive Agents
  • Cyclophosphamide