Hard to see: Systemic lupus erythematous presenting as cranial nerve six palsy: A Case Report

Yema Jalal *, Elizabeth Benge, Gundip Dhillon, Sukhjinder Chahuan, Andrew Kim, Andy He, Aaron Singh and Pinak Shah

Department of Internal Medicine, HCA Healthcare; Mountain View Hospital, Las Vegas, NV, USA.
 
Case Study
World Journal of Advanced Research and Reviews, 2023, 18(01), 551–553
Article DOI: 10.30574/wjarr.2023.18.1.0472
 
Publication history: 
Received on 14 February 2023; revised on 02 April 2023; accepted on 05 April 2023
 
Abstract: 
Systemic Lupus Erythematous (SLE) is an autoimmune disease that can affect multiple organs and can have a wide variety of symptomatic presentations. One rare presenting symptom is oculomotor nerve dysfunction, the following case report is of a 41-year-old female with a past medical history of hypertension and asthma, who was admitted for ocular dysfunction. On physical examination, the patient had an ocular palsy, but the rest of the neurological exam was unremarkable. Imaging modalities such as computed tomography (CT) scan head without contrast, brain magnetic resonance imaging, and computed tomography angiography (CTA) of the head and neck revealed no acute pathology. After a neurological etiology was excluded an autoimmune diagnosis was pursued. Lab results were positive for Anti-Smith, ANA, and Anti-DsDNA. The patient also at this time was also diagnosed with an acute kidney injury and a kidney biopsy that was done later revealed focal lupus nephritis. After starting immunosuppressive therapy, her symptoms improved.
 
Keywords: 
Systemic Lupus Erythematous (SLE); Anti-Double Stranded DNA (Anti-DsDNA); Anti-nuclear antibody (ANA); Computed tomography (CT); Computed tomography angiography (CTA)
 
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