Simultaneous presentation of acute disseminated encephalomyelitis (ADEM) and systemic lupus erythematosus (SLE) after enteroviral infection: can ADEM present as the first manifestation of SLE?

Lupus. 2015 May;24(6):633-7. doi: 10.1177/0961203314560426. Epub 2014 Dec 7.


Central Nervous System (CNS) involvement of Systemic Lupus Erythematosus (SLE) includes a broad range of neuropsychiatric syndromes. Acute Disseminated Encephalomyelitis (ADEM) is a demyelinating CNS disorder characterized by encephalopathy and multifocal lesions predominantly involving the white matter on brain magnetic resonance imaging. ADEM associated with SLE has been only rarely reported. We report an unusual case of a 17-year-old girl who developed ADEM after enteroviral infection as the first manifestation of SLE. The authors emphasize that the patient's illness was preceded by enteroviral infection and that ADEM occurred before any other symptoms of SLE, which makes this case unique.

Keywords: Systemic lupus erythematosus; acute disseminated encephalomyelitis; enteroviral infection.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anti-Inflammatory Agents / administration & dosage
  • Antibodies, Antinuclear / immunology
  • Biopsy
  • Cyclophosphamide / administration & dosage
  • Diagnosis, Differential
  • Encephalomyelitis, Acute Disseminated / cerebrospinal fluid
  • Encephalomyelitis, Acute Disseminated / diagnosis*
  • Encephalomyelitis, Acute Disseminated / pathology
  • Encephalomyelitis, Acute Disseminated / virology
  • Enterovirus Infections / pathology*
  • Female
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Lupus Erythematosus, Systemic / diagnosis*
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / pathology
  • Lupus Erythematosus, Systemic / virology
  • Lupus Vasculitis, Central Nervous System / diagnosis
  • Magnetic Resonance Imaging
  • Methylprednisolone / administration & dosage
  • Pulse Therapy, Drug / methods


  • Anti-Inflammatory Agents
  • Antibodies, Antinuclear
  • Immunosuppressive Agents
  • Cyclophosphamide
  • Methylprednisolone