Diffuse Leukoencephalopathy and Subacute Parkinsonism as an Early Manifestation of Systemic Lupus Erythematosus

Abstract EN

Parkinsonism in SLE is rare.

Diffuse leukoencephalopathy is equally uncommon and is associated with a poor prognosis.

We present a single case of a 50-year-old Filipino man who presented with a generalized discoid rash after starting lisinopril.

The rash persisted despite discontinuation of lisinopril, and over the next three months, he developed rapidly progressive parkinsonism.

Brain MRI showed symmetric confluent T2-hyperintensities involving the white matter and basal ganglia.

Four of the 11 American College of Rheumatology criteria for the classification of SLE were met.

A rheumatologist made a diagnosis of SLE with cutaneous and central nervous system involvement.

Significant neurologic and radiologic improvement occurred following treatment with IV steroids followed by a prolonged taper.

This report highlights a case of subacute parkinsonism with a diffuse leukoencephalopathy as an early manifestation of SLE which resulted in a good recovery following treatment with only immunosuppressive therapy.