Multiple Cerebral Infarctions as an Initial Manifestation of Systemic Lupus Erythematosus with Concomitant Hypereosinophilic SyndromeAkihiro Nakamura1,2*, Tomoya Miyamura1, Brian Wu2 and Eiichi Suematsu1
- *Corresponding Author:
- Akihiro Nakamura
Department of Internal Medicine and Rheumatology
National Hospital Organization
Kyushu Medical Center, Fukuoka, Japan
E-mail: [email protected]
Received date: January 04, 2016; Accepted date: January 25, 2016; Published date: February 17, 2016
Citation: Nakamura A, Miyamura T, Wu B, Suematsu E (2016) Multiple Cerebral Infarctions as an Initial Manifestation of Systemic Lupus Erythematosus with Concomitant Hypereosinophilic Syndrome. Lupus Open Access 1:109.
Copyright: © 2016 Nakamura A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
A 51-year old woman with drowsy consciousness and weakness in bilateral upper and lower extremities was admitted to our hospital. Laboratory test on admission showed eosinophilia, proteinuria, hypoalbuminemia, and elevated creatine kinase-MB. She also had positive antinuclear antibody, anti-ribonucleoprotein antibody and anti- Smith antibody as well as decreased levels of complements. Brain MRI showed multiple cerebral infarcts in both hemispheres. Renal biopsy determined class IV lupus nephritis. Vasculopathy and hypercoagulopathy induced by systemic lupus erythematosus rarely concomitant with hypereosinophilic syndrome were considered as main causes of multiple cerebral infarctions in this patient. The symptoms and laboratory data were gradually recovered with an intravenous methylprednisolone pulse therapy followed by oral prednisolone and monthly intravenous cyclophosphamide therapies.