CASE REPORT: ASEPTIC MENINGITIS - A RARE MANIFESTATION OF SYSTEMIC LUPUS ERYTHEMATOSUS: PATHOGENESIS AND LITERATURE REVIEW
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Abstract
Background: Aseptic meningitis is an extremely rare neuropsychiatric manifestation of systemic lupus erythematosus, occurring in less than 2.7% of patients across various reports. Due to its non-specific presentation, this manifestation is frequently overlooked or misdiagnosed, leading to a delayed clinical diagnosis. Case presentation: A female patient was admitted to the hospital presenting with a headache. Brain magnetic resonance imaging revealed abnormal meningeal enhancement. Cerebrospinal fluid analysis completely ruled out infectious etiologies (bacterial, viral, and fungal), and systemic imaging modalities found no evidence of metastatic leptomeningeal malignancy. Following a multidisciplinary consultation and subsequent immunological testing, the patient was diagnosed with systemic lupus erythematosus based on the 2019 EULAR/ACR classification criteria. Corticosteroid therapy was promptly initiated, resulting in a rapid resolution of both clinical symptoms and neuroimaging findings. Discussion: This case highlights the pivotal role of advanced neuroimaging in the early detection of meningeal involvement. The systematic and sequential exclusion of infectious and malignant causes is a critical step in guiding clinical suspicion toward an underlying systemic autoimmune disease. Conclusion: A comprehensive understanding of the full clinical spectrum of systemic lupus erythematosus, particularly rare neuropsychiatric presentations such as aseptic meningitis, is vital for ensuring timely immunological screening, early therapeutic intervention, and the optimization of patient outcomes.
Keywords
Systemic lupus erythematosus, aseptic meningitis, neuropsychiatric SLE (NPSLE), Autoimmunity
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