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Shrinking central nervous system in systemic lupus erythematosus
  1. C C Mok1,
  2. A Mak1,
  3. E Y K Tsui2
  1. 1Department of Medicine, Tuen Mun Hospital, Hong Kong
  2. 2Department of Radiology, Tuen Mun Hospital, Hong Kong
  1. Correspondence to:
    Dr C C Mok
    Department of Medicine, Tuen Mun Hospital, Tsing Chung Koon Road, New Territories, Hong Kong;

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Neuropsychiatric manifestations of systemic lupus erythematosus (SLE) are diverse and heterogeneous.1 We report a patient who experienced a flare of SLE with subacute transverse myelopathy. Magnetic resonance imaging (MRI) showed atrophy of the entire central nervous system (CNS). Apart from psychosis at SLE onset, there had not been any neuropsychiatric relapses. Progressive atrophy of the CNS should be recognised as an evolving feature of SLE, which may occur without overt neurological symptoms.


A 22 year old Chinese woman with SLE was admitted because of a 2 month history of progressive weakness in her legs and bladder dysfunction. Her SLE had been diagnosed 5 years previously when she presented with polyarthritis, malar rash, cytopenia, psychosis, positive anti-dsDNA, and anti-Ro. A computed tomographic (CT) scan of the brain and cerebrospinal fluid (CSF) findings were unremarkable. Steroid and cyclophosphamide were given, with complete response. She remained well while receiving prednisone and azathioprine maintenance. …

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