Skip to main content
SpringerLink
Log in

Bilateral Optic Neuritis in Pediatric Systemic Lupus Erythematosus with Antiphospholipid Antibody Syndrome

  • Clinical Brief
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. 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.

    Google Scholar 

  2. 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.

    CAS  Google Scholar 

  3. Hackett ER, Martinez RD, Larson PF. Optic neuritis in systemic lupus erythematosus. Arch Neurol. 1974;31:9–11.

    CAS  PubMed  Google Scholar 

  4. Shepherd DL, Downie W, Best PV. Systemic lupus erythematosus and multiple sclerosis. Trans Am Neurol Assoc. 1974;99:173–6.

    CAS  PubMed  Google Scholar 

  5. 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.

    CAS  PubMed  Google Scholar 

  6. Lin YC, Wang AG, Yen MY. Systemic lupus erythematosus associated optic neuritis: clinical experience and literature review. Acta Ophthalmol. 2009;87:204–10.

    Article  PubMed  Google Scholar 

  7. Sanna G, D’Cruz D, Cuadrado MJ. Cerebral manifestations in the antiphospholipid (Hughes) syndrome. Rheum Dis Clin North Am. 2006;32:465–90.

    Article  PubMed  Google Scholar 

  8. Peponis V, Kyttaris VC, Tyradellis C, Vergados I, Sitaras NM. Ocular manifestations of systemic lupus erythematosus: a clinical review. Lupus. 2006;15:3–12.

    Article  CAS  PubMed  Google Scholar 

  9. Wilson WB. Visual evoked response differentiation of ischemic optic neuritis from the optic neuritis of multiple sclerosis. Am J Ophthalmol. 1978;86:530–5.

    CAS  PubMed  Google Scholar 

  10. 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.

    CAS  PubMed  Google Scholar 

Download references

Conflict of interest

None stated.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children’s Hospital, New Delhi, 110001, India

    Soumya Patra, Sriram Krishnamurthy, Anju Seth & Satinder Aneja

  2. Department of Ophthalmology, Lady Hardinge Medical College, New Delhi, India

    Sarita Beri

Authors
  1. Soumya Patra
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sriram Krishnamurthy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anju Seth
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sarita Beri
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Satinder Aneja
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Soumya Patra.

Additional information

Contributors: Soumya Patra, Sriram Krishnamurthy, Sarita Beri, Anju Seth and Satinder Aneja managed the patient. Soumya Patra and Sriram Krishnamurthy reviewed the literature and drafted the manuscript. Satinder Aneja critically reviewed the manuscript. All authors approved the final version of the manuscript.

Funding: none

Rights and permissions

Reprints and permissions

About this article

Cite this article

Patra, S., Krishnamurthy, S., Seth, A. et al. Bilateral Optic Neuritis in Pediatric Systemic Lupus Erythematosus with Antiphospholipid Antibody Syndrome. Indian J Pediatr 78, 234–236 (2011). https://doi.org/10.1007/s12098-010-0228-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-010-0228-5

Keywords

Search

Navigation