Bilateral Optic Neuritis in Pediatric Systemic Lupus Erythematosus with Antiphospholipid Antibody Syndrome
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Bilateral optic neuritis is an extremely uncommon complication of pediatric systemic lupus erythematosus and sporadic cases are reported in the literature. The authors describe an 11-yr-old girl who presented with fever and progressively increasing pallor for 4 months, headache for 7 days, severe anemia and hepatosplenomegaly. Soon after admission, she developed rapid deterioration of vision, worsening to no perception of light with afferent pupillary defect. Fundoscopy showed bilateral optic neuritis. Investigations revealed autoimmune hemolytic anemia and thrombocytopenia. Anti-dsDNA and anti-phospholipid antibodies were positive. Magnetic resonance venography showed multiple thrombi in the cerebral venous sinuses, for which anticoagulant therapy was initiated. She was managed with intravenous methylprednisolone followed by cyclophosphamide pulse therapy for 6 months along with oral prednisolone. Though she went into remission, visual outcome has been dismal, with development of bilateral optic atrophy, and absence of perception of light.
- Wei W, Zerfoss E, Ashker L, Cantore WA. Bilateral optic neuritis in pediatric systemic lupus erythematous associated with antiphospholipid antibodies and neuromyelitis optica immunoglobin. J Pediatr Ophthalmol Strabismus. 2009;10:1–4. doi:10.3928/01913913-20090701-11.
- Vitale C, Kahn MF, de Seze M. Nevrite optique, myelite et maladie lupique: a propos de deux observations. Ann Med Interne (Paris). 1973;124:211–6.
- Hackett ER, Martinez RD, Larson PF. Optic neuritis in systemic lupus erythematosus. Arch Neurol. 1974;31:9–11.
- Shepherd DL, Downie W, Best PV. Systemic lupus erythematosus and multiple sclerosis. Trans Am Neurol Assoc. 1974;99:173–6.
- Ahmadieh H, Roodpeyma S, Azarmina M, Sheilian M, Sajjadi SH. Bilateral simultaneous optic neuritis in childhood systemic lupus erythematosus. J Neuroophthalmol. 1994;14:84–6.
- Lin YC, Wang AG, Yen MY. Systemic lupus erythematosus associated optic neuritis: clinical experience and literature review. Acta Ophthalmol. 2009;87:204–10. CrossRef
- Sanna G, D’Cruz D, Cuadrado MJ. Cerebral manifestations in the antiphospholipid (Hughes) syndrome. Rheum Dis Clin North Am. 2006;32:465–90. CrossRef
- Peponis V, Kyttaris VC, Tyradellis C, Vergados I, Sitaras NM. Ocular manifestations of systemic lupus erythematosus: a clinical review. Lupus. 2006;15:3–12. CrossRef
- Wilson WB. Visual evoked response differentiation of ischemic optic neuritis from the optic neuritis of multiple sclerosis. Am J Ophthalmol. 1978;86:530–5.
- Meyer R, Weissert R, Diem R, Storch MK, Graff KL, Kramer B, et al. Acute neuronal apoptosis in a rat model of multiple sclerosis. J Neurosci. 2001;21:6214–20.
- Bilateral Optic Neuritis in Pediatric Systemic Lupus Erythematosus with Antiphospholipid Antibody Syndrome
The Indian Journal of Pediatrics
Volume 78, Issue 2 , pp 234-236
- Cover Date
- Print ISSN
- Online ISSN
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- Optic neuritis
- Autoimmune hemolytic anemia
- Systemic lupus erythematosus
- Anti-phospholipid antibody syndrome
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- Author Affiliations
- 1. Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, 110001, India
- 2. Department of Ophthalmology, Lady Hardinge Medical College, New Delhi, India