Follow up
Based on clinical, laboratory, and radiological findings, the
professional diagnosis was autoimmune SLE-related encephalitis. Lumbar
puncture, which was previously performed, showed normal cyto-biochemical
markers. Cerebrospinal fluid (CSF) bacteriological, mycological, and
mycobacteriological cultures were negative. On 07/03/2022, she followed
up with MRI, EEG, anti dsDNA, and C3 and C4 complement. MRI showed
similar changes that were initially seen with mild signal reductions.
EEG revealed no abnormal brain activity. Anti-dsDNA was decreased to 1.9
IU/mL compared to the first time, which was 81.7 IU/mL. C3 was 135mg/dL
compared to the first time, 90mg/dL, and C4 was 26mg/dL compared to the
first time, 12mg/Dl. She is on regular follow-ups by neurology and
rheumatology teams. The plan is to taper down her steroid dose to off.
The neurology team will follow the patient to adjust her anti-seizure
medication. The patient became morbidly obese < 48 BMI and is
a candidate for obesity management; the obesity team will follow her,
and she will be followed closely by rheumatology for any disease
reactivation and medication adjustment.