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Lupus cerebritis
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Lupus cerebritis

Contributors: Andrea Wasilewski MD, Benjamin L. Mazer MD, MBA, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed


Lupus cerebritis is an inflammatory injury in the central nervous system secondary to systemic lupus erythematosus (SLE). Clinically, however, lupus cerebritis is often diagnosed by the presence of neuropsychiatric symptoms in a patient with SLE that cannot be explained by a more specific physiologic mechanism, such as stroke or vasculitis. The clinical presentation of lupus cerebritis is diverse, and includes focal neurologic deficits, encephalopathy, seizures, stroke, psychosis, and headache. Its onset may be acute or subacute.

Neurologic symptoms occur in the majority of patients with SLE at some point during their illness. Symptoms occur due to multiple mechanisms including vasculopathy, vasculitis, and autoantibodies, and may be augmented by other complications of SLE such as metabolic complications, infections, and treatment toxicities.

Lupus cerebritis must be distinguished from other common sequelae of SLE or its treatment, such as ischemia, infection, or uremia. Lupus cerebritis is usually treated with immunosuppression, such as corticosteroids.


M32.19 – Other organ or system involvement in systemic lupus erythematosus

95644001 – Systemic lupus erythematosus encephalitis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Encephalitis
  • Meningitis (eg, Aseptic meningitis, Bacterial meningitis, Fungal meningitis)
  • Multiple sclerosis
  • Acute demyelinating encephalomyelitis
  • Malignancy (particularly primary central nervous system, hematopoietic, metastasis)
  • Human immunodeficiency virus primary infection
  • Progressive multifocal leukoencephalopathy
  • Cerebral stroke
  • Intracranial hemorrhage (Cerebral stroke, Subarachnoid hemorrhage)
  • Trauma
  • Lyme disease
  • Tertiary syphilis
  • Metabolic encephalopathy (eg, Hypoglycemia, Hyponatremia)
  • Drug-induced encephalopathy (eg, Opioid use disorder, Benzodiazepine use disorder)
  • Paraneoplastic syndrome (eg, Paraneoplastic encephalomyelitis)
  • Free-living amoeba infection (eg, Naegleria)
  • Ehrlichiosis
  • Malaria
  • Tuberculosis
  • Seizure
  • Rocky Mountain spotted fever

Best Tests

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Management Pearls

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Last Reviewed:02/13/2019
Last Updated:03/03/2019
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Lupus cerebritis
A medical illustration showing key findings of Lupus cerebritis : Seizures, Headache, Anxiety, Choreiform movements, Mental status alteration, Neuropathy peripheral, Memory loss, Depression
Copyright © 2024 VisualDx®. All rights reserved.