Partial epilepsy as an initial manifestation in bullous systemic lupus erythematosus

Pan, Meng; Tang, H-D; Zhu, H-Q; Dong, Jie; Gill, JF; Zheng, Jie

doi:10.1177/0961203311398511

Cited by 6 publications

(6 citation statements)

References 11 publications

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“…Unlike previous reports where there is a predilection for lesions to develop on the upper trunk, neck and supraclavicular regions, and a tendency for sun-exposed areas, our study showed generalized distribution in the majority of patients and pure photodistribution was only seen in one patient. 11,12 This finding may reflect the autoimmune nature of BSLE, where lesions can occur on normal skin without a definite predilection for a sun-exposed site or overlying lesional erythema, which is useful to differentiate BSLE from LE-specific vesiculobullous diseases. Mucosal involvement was seen in 40% of the patients.…”

Section: Discussionmentioning

confidence: 98%

“…14,15 Other reported systemic associations, although not frequently documented, are hematologic, neurologic, arthritis and serositis. 11,16,17 Hematologic (100%) and renal (90%) involvement were the most frequent associated systemic abnormalities, followed by polyarthritis (40%) and serositis (40%). However, hematologic abnormalities reported in our series (other than AIHA) could also be attributed to immunosuppressive agents given concomitantly to the patients with active SLE.…”

Section: Discussionmentioning

confidence: 99%

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A 12-year retrospective review of bullous systemic lupus erythematosus in cutaneous and systemic lupus erythematosus patients

Chanprapaph

Sawatwarakul

Vachiramon

2017

Lupus

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Objective The aim of this study was to investigate the clinical features, laboratory findings, systemic manifestations, treatment and outcome of patients with bullous systemic lupus erythematosus in a tertiary care center in Thailand. Methods We performed a retrospective review from 2002 to 2014 of all patients who fulfilled the diagnostic criteria for bullous systemic lupus erythematosus to evaluate for the clinical characteristics, extracutaneous involvement, histopathologic features, immunofluorescence pattern, serological abnormalities, internal organ involvement, treatments and outcome. Results Among 5149 patients with cutaneous lupus erythematosus and/or systemic lupus erythematosus, 15 developed vesiculobullous lesions. Ten patients had validation of the diagnosis of bullous systemic lupus erythematosus, accounting for 0.19%. Bullous systemic lupus erythematosus occurred after the diagnosis of systemic lupus erythematosus in six patients with a median onset of 2.5 months (0-89). Four out of 10 patients developed bullous systemic lupus erythematosus simultaneously with systemic lupus erythematosus. Hematologic abnormalities and renal involvement were found in 100% and 90%, respectively. Polyarthritis (40%) and serositis (40%) were less frequently seen. Systemic corticosteroids, immunosuppressants, antimalarials and dapsone offered resolution of cutaneous lesions. Conclusion Bullous systemic lupus erythematosus is an uncommon presentation of systemic lupus erythematosus. Blistering can occur following or simultaneously with established systemic lupus erythematosus. We propose that clinicians should carefully search for systemic involvement, especially hematologic and renal impairment, in patients presenting with bullous systemic lupus erythematosus.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

A 12-year retrospective review of bullous systemic lupus erythematosus in cutaneous and systemic lupus erythematosus patients

Chanprapaph

Sawatwarakul

Vachiramon

2017

Lupus

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“…Beyinde yapısal lezyonu olan hastalarda parenkimal iritasyon zemininde semptomatik epilepsi ortaya çıkabilmekle birlikte, lezyon olmadan da nöbet izlenebilir. [9] Olgumuzda beyin MRG incelemesinde, nöbet tipi ve EEG'deki odak ile uyumlu olacak şekilde, sol pariyetal bölgede parasagittal alanda akut arteryal infarkt ile uyumlu görünüm mevcuttu.…”

Section: Discussionunclassified

Super refractory status epilepticus of neuropsychiatric systemic lupus erythematosis: a rare case

Göl¹,

Yetkin²,

Köse³

et al. 2018

Epilepsi

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ÖzetSistemik lupus eritematozus (SLE) yaygın organ tutulumu ile giden, otoimmün bir hastalıktır. Merkezi sinir sistemi tutulumuna nöropsikiyatrik SLE (NP-SLE) adı verilmekte olup, NP-SLE'de %6.7-14.4 arasında epileptik nöbet görülmektedir. NP-SLE hastalarında epilepsinin prognozu oldukça iyidir, genellikle uzun süreli antiepileptik tedaviye ihtiyaç duyulmaz ve hastaların sadece %24'ünde politerapi gerekmektedir. Nöbetlerin yarısından azı fokal başlangıçlı nöbet şeklinde olup, nöropsikiyatrik-SLE de fokal başlangıçlı nöbete sekonder status epileptikus nadir görülmektedir. On yedi yaşında SLE tanısı konulan sağ alt ekstremitede güçsüzlük ile başvuran takiplerinde farkındalığın bozulduğu fokal başlangıçlı nöbet gözlenen, antiepileptik tedaviye rağmen nöbetleri kontrol altına alınamayan hasta, süper refrakter status epileptikusun tedavi yönetimine dikkat çekmek ve nöropsikiyatrik-SLE' yi gözden geçirmek için sunulmuştur.Anahtar sözcükler: Fokal nöbetler; sistemik lupus eritematozus; süper refrakter status epileptikus. SummarySystemic lupus erythematosus (SLE) is an autoimmune disease with extensive organ involvement. Neuropsychiatric-SLE (NP-SLE) includes the involvement of the central nervous system, and has an epileptic seizure rate of 6.7% to 14.4%. The prognosis of epilepsy in NP-SLE patients is fairly good, usually long-term antiepileptic treatment is not needed and only 24% of patients require polytherapy. Less than half of seizures are focal onset seizures and focal onset seizure secondary status epilepticus is rarely seen in NP-SLE. Presently described is the case of a 17-year-old woman with focal onset seizures and impaired awareness with right lower extremity weakness who had been diagnosed with SLE and whose seizures were not controlled despite antiepileptic treatment. This report was presented to draw attention to the management of super refractory status epilepticus and to review neuropsychiatric-SLE.

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“…Pruritus is usually not present. There is a predilection of lesions to develop on the face, upper trunk, neck, supraclavicular regions, and axillary folds, and tendency for sun-exposed areas; however, generalized distribution is not uncommon 50,51. Mucosal involvement, especially oral mucosa, can occur in 30%–40% of cases 52,53.…”

Section: Le-aspecific Vesiculobullous Diseasesmentioning

confidence: 99%

<p>Vesiculobullous diseases in relation to lupus erythematosus</p>

Rutnin

Chanprapaph

2019

CCID

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Vesiculobullous lesions in lupus erythematosus (LE) are a rare cutaneous manifestation of cutaneous and/or systemic LE with variable presentation. While the minor forms of LE-associated vesiculobullous disease may cause disfigurement and discomfort, the severe forms can present with hyperacute reaction and life-threatening consequences. Specific LE and aspecific cutaneous LE are defined by the presence or absence of interface change on histopathology that can be applied to vesiculobullous diseases in relation to LE. However, the diagnosis of LE-associated vesiculobullous diseases remains difficult, due to the poorly defined nosology and the similarities in clinical and immunohistopathological features among them. Herein, we thoroughly review the topic of vesiculobullous skin disorders that can be encountered in LE patients and organize them into four groups: LE-specific and aspecific vesiculobullous diseases, LE-related autoimmune bullous diseases, and LE in association to non-autoimmune conditions. We sought to provide an updated overview highlighting the pathogenesis, clinical, histological, and immunopathological features, laboratory findings, and treatments and prognosis among vesiculobullous conditions in LE.

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Partial epilepsy as an initial manifestation in bullous systemic lupus erythematosus

Cited by 6 publications

References 11 publications

A 12-year retrospective review of bullous systemic lupus erythematosus in cutaneous and systemic lupus erythematosus patients

A 12-year retrospective review of bullous systemic lupus erythematosus in cutaneous and systemic lupus erythematosus patients

Super refractory status epilepticus of neuropsychiatric systemic lupus erythematosis: a rare case

<p>Vesiculobullous diseases in relation to lupus erythematosus</p>

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