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A case report of systemic lupus erythematosus combined with central serous chorioretinopathy treated with glucocorticoids.

ABSTRACT: Glucocorticoids are generally contraindicated for use in central serous chorioretinopathy (CSC) because their use is considered to be an independent risk factor for CSC. There are rare reports regarding the treatment of systemic lupus erythematosus (SLE) combined with CSC. This current case report describes a rare case of a 24-year-old female patient with severely active SLE combined with CSC, whose vision was significantly restored after she was administered 120 mg methylprednisolone intravenously once a day for 3 days. This case report presents the clinical characteristics for the first time in terms of distinguishing between typical CSC and lupus chorioretinopathy. It also provides a review of the relevant literature. In patients with clinically severe active lupus nephritis combined with bilateral lupus chorioretinopathy, timely systemic application of appropriate doses of glucocorticoids is the preferred method to control the primary disease and serious ocular complications.

SUBMITTER: Rao Q

PROVIDER: S-EPMC10068993 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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A case report of systemic lupus erythematosus combined with central serous chorioretinopathy treated with glucocorticoids.

Rao Qingqing Q Ku Ming M Wan Qijun Q

The Journal of international medical research 20230301 3

Glucocorticoids are generally contraindicated for use in central serous chorioretinopathy (CSC) because their use is considered to be an independent risk factor for CSC. There are rare reports regarding the treatment of systemic lupus erythematosus (SLE) combined with CSC. This current case report describes a rare case of a 24-year-old female patient with severely active SLE combined with CSC, whose vision was significantly restored after she was administered 120 mg methylprednisolone intravenou ...[more]

PMID: 36999279

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Project description:ObjectiveSystemic lupus erythematosus (SLE) is a multisystem-involved, highly heterogeneous autoimmune disease with diverse clinical manifestations. We report an extremely rare case of SLE with severe diffuse myocardial hypertrophy.MethodsThe patient's echocardiography and cardiac magnetic resonance imaging (CMR) results indicated diffuse myocardial hypertrophy. After excluding coronary atherosclerosis, hypertensive cardiomyopathy, drug toxicity, and other causes, the patient was diagnosed with SLE-specific cardiomyopathy. Medications such as hormones, antimalarials, immunosuppressants, and biologics were administered.ResultsAncillary test results were as follows: hs-cTnI: 0.054 ng/mL (0-0.016); NTproBNP: 1594.0 pg/mL (<150); A contrast-enhanced CMR revealed the diffuse thickening of the left ventricular wall with multiple abnormal enhancements, reduced left ventricular systolic and diastolic function, and moderate amount of pericardial effusion. Endomyocardial myocardial biopsy was performed, showing cardiomyocyte hypertrophy and degeneration, and no changes in myocarditis or amyloidosis. The pathology viewed by electron microscopy showed increased intracellular glycogen in the myocardium, and no hydroxychloroquine-associated damage in the myocardium. The 24-h ambulatory blood pressure and contrast-enhanced computed tomography of coronary arteries were normal. The diagnosis of SLE-specific cardiomyopathy was clear. The myocardial hypertrophy showed reversible alleviation following treatment with high-dose corticosteroids. CMR results before and after treatment were as follows: interventricular septum, pretreatment (28) versus post-treatment (22) mm; left ventricular inferior wall, pretreatment (18-21) versus post-treatment (12-14) mm; left ventricular lateral wall, pretreatment (17-18) versus post-treatment (10-12) mm; pericardial effusion (left ventricular lateral wall), pretreatment (25) versus post-treatment (12) mm; left ventricular ejection fraction, pretreatment (38.9%) versus post-treatment (66%).ConclusionMyocardial hypertrophy may be an important sign of active and prognostic assessment in SLE diagnosis and management. Similarly, when encountering cases of myocardial hypertrophy, the possibility of autoimmune disease should be considered in addition to common causes.

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A case report of systemic lupus erythematosus combined with central serous chorioretinopathy treated with glucocorticoids.

Publications

A case report of systemic lupus erythematosus combined with central serous chorioretinopathy treated with glucocorticoids.

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