© 2004 by BMJ Publishing Group Ltd & European League Against Rheumatism
LESSON OF THE MONTH
Proptosis can be the presenting feature of systemic lupus erythematosus
Series editor: Anthony D Woolf
1 University of Wales College of Medicine, Cardiff, UK
2 Royal Gwent Hospital, Newport, UK
Correspondence to:
Correspondence to:
Dr S Siebert
Department of Rheumatology, University of Wales College of Medicine, Heath Park, Cardiff, CF14 4XW, UK; sieberts@cardiff.ac.uk
Accepted 2 March 2004
Abbreviations: ANF, antinuclear factor; CT, computed tomography; MRI, magnetic resonance imaging; SLE, systemic lupus erythematosus
Keywords: antinuclear factor; systemic lupus erythematosus; orbital pseudotumour; proptosis
| The first 150 words of the full text of this article appear below. |
The patient, a 23 year old student, initially presented to another hospital with swelling of his left eye. Clinical examination showed only isolated proptosis of his left eye. A computed tomographic (CT) scan of his orbits was consistent with orbital pseudotumour, for which he was given a short course of oral steroids, with good clinical response. He was then lost to follow up as he returned home from his studies.
A few months later he presented to the physicians in our hospital with a 2 week history of painful swelling of his left eye, accompanied by polyarthralgia, fever with rigors, and lethargy. Further questioning showed he had mild photosensitivity and frequent mouth ulcers of several months’ duration. He had not been receiving any other drug before the onset of symptoms. At the time of admission he was clearly unwell and extremely lethargic, with a temperature of 37.4°C. He had no
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