Successful treatment with rituximab in a patient with lupus cerebritis and posterior reversible encephalopathy syndrome: a case report

Background: Neuropsychiatric systemic lupus erythematosus (NPSLE) has a diverse and broad spectrum of severity prognosis, with some devastating manifestations. However, its diagnosis treatment remain unclear controversial. Case Report: A 19-year-old woman SLE presented fever, headache, quadriparesis, tremor. Brain magnetic resonance imaging (MRI) showed sulcal enhancement in the cortical sulcus, intravenous methylprednisolone (500 mg/day) immunoglobulin (2 g/kg for 5 days) were started under suspicion aseptic meningitis. patient’s neurologic symptoms worsened; brain MRI newly developed parenchymal lesion, suggesting cerebritis posterior reversible encephalopathy syndrome. Two cycles rituximab (850 mg/day, 1-week interval) administered refractory NPSLE. Her gradually improved after second cycle, she was discharged minimal symptoms. Conclusion: Rituximab may be therapeutic option cerebritis. Further research is needed to accurately determine efficacy.