Summary
A patient is described who developed acute proptosis, a rare complication of systemic lupus erythematosus, 16 years after the onset of the disease. Treatment with intravenous methylprednisolone produced rapid improvement, but swelling recurred a few days later. Intravenous corticosteroid was again effective and was continued orally without further episodes of proptosis. This patient is unusual in the long period of mild disease before the development of systemic complications, and in having antibodies to nuclear ribonucleoprotein but persistently normal titres of DNA-binding antibodies in her serum.
Similar content being viewed by others
References
Tan, E.M., Cohen, A.S., Fries, J.F., et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982, 25, 1271–1277.
Garner, A. Pathology of ‘speudotumour’ of the orbit: a review. J Clin Pathol 1973, 26, 639–648.
Haynes, B.F., Fishman, M.L., Fauci, A.S., Wolff, S.M. The ocular manifestations of Wegener's granulomatosis. Am J Med 1977, 63, 131–141.
Hollenhorst, R.W., Henderson, J.W. The ocular manifestations of the diffuse collagen diseases. Am J Med Sci 1951, 221, 211–222.
Walton, E.W. Pseudo-tumour of the orbit and polyarteritis nodosa. J Clin Pathol 1959, 12, 419–426.
Talal, M., Blunim, J.J. The development of malignant lymphoma in the course of Sjögren's syndrome. Am J Med 1964, 36, 529–540.
Burkhalter, E. Unique presentation of systemic lupus erythematosus. Arthritis Rheum 1973, 16, 428.
Brenner, E.H., Shock, J.P. Proptosis secondary to systemic lupus erythematosus. Arch Ophthalmol 1974, 91, 81–82.
Wilkinson, L.S., Panush, R.S. Exophthalmos associated with systemic lupus erythematosus. Arthritis Rheum 1975, 18, 188–189.
Nowinski, T., Bernardino, V., Naidoff, M., Parrish, R. Ocular involvement in lupus erythematosus profundus (panniculitis). Ophthalmology 1982, 89, 1149–1154.
Grimson, B.S., Simons, K.B. Orbital inflammation, myositis, and systemic lupus erythematosus. Arch Ophthalmol 1983, 101, 736–738.
Bankhurst, A.D., Carlow, T.J., Reidy, R.W. Exophthalmos in systemic lupus erythematosus. Ann Ophthalmol 1984, 16, 669–671.
Leonard, T.J.K., Graham, E.M., Stanford, M.R., Sanders, M.E. Graves' disease presenting with bilateral acutc painful proptosis, ptosis, ophthalmoplegia, and visual loss. Lancet 1984, 2, 431–433.
Fessel, W.J. Megadose corticosteroid therapy in systemic lupus erythematosus. J Rheumatol 1980, 7, 486–500.
Kimberly, R.P. Pulse methylprednisolone in SLE. Clin Rheum Dis 1982, 8, 261–278.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gray, R.E.S., Jenkins, E.A., Hall, M.A. et al. Recurrent acute proptosis in atypical systemic lupus erythematosus. Clin Rheumatol 8, 528–532 (1989). https://doi.org/10.1007/BF02032109
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02032109