[Spontaneous intracranial hypotension: A rare cause of headache in systemic lupus erythematosus].

La Revue de médecine interne
P BrangerN Martin Silva

Abstract

Spontaneous intracranial hypotension (SIH), a rare cause of headache, may be idiopathic or secondary, in particular to Systemic Lupus Erythematosus (SLE) where it remains exceptionally evoked or documented. A 36-year-old woman presented with postural headache, recurrent nausea and vomiting. The discovery of a nephrotic syndrome led to the diagnosis of SLE with lupus nephropathy (class IV-G-(A)). A brain MRI showed signs of intracranial hypotension with tonsil ptosis and a left parietal hypersignal, and leading to a diagnosis of neurolupus with SIH. Treatment with prednisone, cyclophosphamide, and then mycophenolate mofetil allowed a rapid complete response of all systemic, renal and neurological manifestations, including the iconographic signs of intracranial hypotension. Headaches are frequent and often unexplained during SLE. Their orthostatic character should, if appropriate, suggests a SIH and lead to perform a brain MRI, even in the absence of other neurological signs.

References

Jan 14, 2004·Kidney International·Jan J WeeningUNKNOWN Renal Pathology Society Working Group on the Classification of Lupus Nephritis
Mar 3, 2007·Nihon Rinshō Men'eki Gakkai kaishi = Japanese journal of clinical immunology·Sae OchiNobuyuki Miyasaka
Mar 17, 2012·European Journal of Nuclear Medicine and Molecular Imaging·Hanae AraiYoshihiro Nishiyama
Jun 17, 2014·Modern Rheumatology·Daisuke AndoJun Soma
Aug 21, 2019·Radiology Case Reports·Dan Isaac Cohen-AddadVinodkumar Velayudhan

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