# Rare insights: Atypical MRI features of juvenile SLE

## TL;DR

This paper presents a rare case of juvenile SLE with unusual MRI findings that suggest CNS vasculitis.

## Contribution

The paper highlights atypical MRI features in a young SLE patient with neurological symptoms.

## Key findings

- A 5-year-old girl with juvenile SLE showed focal grey and white matter lesions on MRI.
- Neurological symptoms were limited to fever and headache in this case.
- MRI findings were not diagnostic but were part of the initial evaluation for CNS lupus vasculitis.

## Abstract

Patients with systemic lupus erythematosus (SLE) frequently show symptoms of central nervous system involvement, termed neuropsychiatric SLE (NPSLE). Central nervous system (CNS) vasculitis is one of the neurological pathologies seen in CNS lupus. Patients with NPSLE typically present with nonspecific symptoms such as headache and cognitive impairment. Due to a lack of specific neuroradiological findings, diagnosis and management of such patients remain a big challenge. We report a 5-year-old girl who presented with fever and headache as the only neurological symptoms. Magnetic resonance imaging (MRI) of the brain showed focal grey and white matter lesions, suggestive of inflammatory or demyelinating ethology. Even though MR imaging findings may not be diagnostic of CNS lupus vasculitis, the study is routinely performed as a part of initial evaluation in patients with juvenile SLE showing neurological signs and symptoms.