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Case Report



Diagnostic and management problems in patient with systemic lupus erythematosus (SLE) and anti N-methyl-D-Aspartate receptor (NMDAR) encephalitis

Gusti Ngurah Arika, Gede Kambayana, Pande Ketut Kurniari.




Abstract
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Sistemic Lupus Erythematosus (SLE) is a chronic multisystem inflammatory autoimmune disease with unknown etiology and broad clinical spectrum presentation. In several case, there is cross-reaction between anti-DNA antibody and-N-methyl-D-Aspartate Receptor (NMDAR) subunit 2 (NR2) that can implicated to multiple brain disorders including stroke, chronic neurodegeneration, epilepsy, and schizophrenia. SLE with anti-NMDAR encepalitis are rare cases and there was difficulty in establishing the diagnosis and providing therapy because of symptoms and signs in patients who are not specific and there is no established therapeutic protocol for this disease. A 15-year-old female with encephalitis cause by neuropsichyatric SLE and anti-NMDAR which was successfully treated with highdose steroid followed by administration of cyclophosphamide and rituximab.

Key words: SLE, Encephalitis, Anti-NMDAR






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