Haemorrhage Secondary to Cerebral Aneurysm in a Senegalese Patient with Systemic Lupus Erythematosus: A Case Report

Baïdy Sy Kane,Maïmouna Sow,Awa Cheikh Ndao,Souhaibou Ndongo,Mohamed Dieng,Abdoulaye Pouye,Boundia Djiba

doi:10.4236/health.2019.1112123

Abstract

Introduction: Hemorrhage by ruptured cerebral aneurysm is a rare and severe complication of systemic lupus erythematosus (SLE). We reported a case of this complication. Observation: A 24-year-old woman black Senegalese patient was followed in our department since for a systemic lupus with cutaneous and articular involvement and class III and V Lupus nephritis. She was readmitted for acute headache and early postprandial vomiting. The examination showed a meningeal syndrome, a subacute lupus eruption in the trunk, panniculitis and fever. The cerebral computer tomography showed spontaneous haemorrhage from saccular aneurysm. She was managed by immediate aneurysm clipping and medical treatment including bolus of methylprednisolone and immunosuppressive therapy was maintained. The outcome was favourable, but there was neurological damage such as brachial weakness. Conclusion: Hemorrhage by ruptured cerebral aneurysm is a rare and severe complication of SLE. The risk of damage is also significant. Immediate neurosurgical management and aggressive medical treatment may improve the prognosis.

Highlights

Hemorrhage by ruptured cerebral aneurysm is a rare and severe complication of systemic lupus erythematosus (SLE)
Observation: A 24-year-old woman black Senegalese patient was followed in our department since for a systemic lupus with cutaneous and articular involvement and class III and V Lupus nephritis
In 1999, an expert panel of the American College of Rheumatology (ACR) defined 19 clinical situations that are observed with neuro-psychiatric systemic lupus erythematosus” (NPSLE)

Summary

Introduction

Systemic Lupus Erythematosus (SLE) is a complex systemic auto-immune disease characterized by a wide spectrum of clinical, laboratory and immunological. It represents a common systemic autoimmune disease of unknown cause [2]. In 1999, an expert panel of the American College of Rheumatology (ACR) defined 19 clinical situations that are observed with NPSLE. This classification includes a wide range of syndromes and distinguishes between central and peripheral manifestations of NPSLE (12 in the central nervous system (CNS) and 7 in the peripheral nervous system) [7]. Subarachnoid haemorrhages (SAH) secondary to cerebral aneurysms related to SLE are exceptionally reported [13].

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Conclusion