{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T05:52:39Z","timestamp":1771653159052,"version":"3.50.1"},"reference-count":26,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,12,23]]},"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>A man in his 30s, who presented with fevers and a diffuse purpuric rash, developed sudden-onset visual loss on day 2. He was unable to perceive light in either eye. Examination by a neurologist confirmed cortical blindness, and the MRI showed subtle juxtacortical infarcts and leptomeningeal enhancement in the occipital region. Further history taken in the patient\u2019s native language revealed a history of untreated systemic lupus erythematosus. A diagnosis of central nervous system lupus was made and he was treated promptly with pulse methylprednisolone and cyclophosphamide. His vision gradually improved to 80% on day 10 and eventually returned to baseline. He continued with high-dose prednisolone and monthly cyclophosphamide for 6 months and remained on hydroxychloroquine and mycophenolate mofetil with no relapses. This case shows the importance of approaching the uncommon but potentially dangerous issue of acute visual loss with a broad differential.<\/jats:p>","DOI":"10.1136\/bcr-2022-253096","type":"journal-article","created":{"date-parts":[[2023,1,2]],"date-time":"2023-01-02T10:55:23Z","timestamp":1672656923000},"page":"e253096","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Acute cortical blindness caused by neuropsychiatric systemic lupus erythematosus"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1140-8741","authenticated-orcid":false,"given":"Alex Kaimin","family":"Wong","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Box Hill Hospital, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David Gordon","family":"Darby","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia"},{"name":"Eastern Neurosciences, Box Hill Hospital, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Fong","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Box Hill Hospital, Melbourne, Victoria, Australia"},{"name":"Eastern Clinical Research Unit, Monash University, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,1,2]]},"reference":[{"key":"2025082723233057000_16.1.e253096.1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-018-0156-8"},{"key":"2025082723233057000_16.1.e253096.2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199904)42:4<599::AID-ANR2>3.0.CO;2-F"},{"key":"2025082723233057000_16.1.e253096.3","doi-asserted-by":"crossref","DOI":"10.1111\/1756-185X.12337","article-title":"Neuro-ophthalmologic manifestations of systemic lupus erythematosus: a systematic review","volume":"17","author":"Man","year":"2014","journal-title":"Int J Rheum Dis"},{"key":"2025082723233057000_16.1.e253096.4","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2004.025528"},{"key":"2025082723233057000_16.1.e253096.5","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s13365-019-00820-4","article-title":"Varicella zoster virus (VZV) oculomeningoencephalomyeloradiculitis: a previously undescribed constellation","volume":"26","author":"Tizazu","year":"2020","journal-title":"J Neurovirol"},{"key":"2025082723233057000_16.1.e253096.6","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.75.882.201"},{"key":"2025082723233057000_16.1.e253096.7","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1148\/rg.210045","article-title":"Central nervous system systemic lupus erythematosus: pathophysiologic, clinical, and imaging features","volume":"42","author":"Ota","year":"2022","journal-title":"Radiographics"},{"key":"2025082723233057000_16.1.e253096.8","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.jns.2017.01.031","article-title":"Vision loss in tuberculous meningitis","volume":"375","author":"Garg","year":"2017","journal-title":"J Neurol Sci"},{"key":"2025082723233057000_16.1.e253096.9","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu216"},{"key":"2025082723233057000_16.1.e253096.10","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/j.alit.2016.12.009","article-title":"Drug eruption caused by esomeprazole: a case report and mini-review","volume":"66","author":"Taura","year":"2017","journal-title":"Allergol Int"},{"key":"2025082723233057000_16.1.e253096.11","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.anai.2016.08.005","article-title":"Cutaneous leukocytoclastic vasculitis due to amoxicillin hypersensitivity","volume":"117","author":"S\u00e1enz de Santa Mar\u00eda Garc\u00eda","year":"2016","journal-title":"Ann Allergy Asthma Immunol"},{"key":"2025082723233057000_16.1.e253096.12","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1007\/BF01970967","article-title":"Clarithromycin-induced leukocytoclastic vasculitis","volume":"12","author":"de Vega","year":"1993","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2025082723233057000_16.1.e253096.13","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1A124"},{"key":"2025082723233057000_16.1.e253096.14","first-page":"12","article-title":"Drug-induced vasculitis: a clinical and pathological review","volume":"70","author":"Radi\u0107","year":"2012","journal-title":"Neth J Med"},{"key":"2025082723233057000_16.1.e253096.15","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1007\/s00296-019-04445-y","article-title":"Anti-smith antibody is associated with disease activity in patients with new-onset systemic lupus erythematosus","volume":"39","author":"Ahn","year":"2019","journal-title":"Rheumatol Int"},{"key":"2025082723233057000_16.1.e253096.16","doi-asserted-by":"publisher","DOI":"10.1007\/BF02231577"},{"key":"2025082723233057000_16.1.e253096.17","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-015-2941-y"},{"key":"2025082723233057000_16.1.e253096.18","doi-asserted-by":"publisher","DOI":"10.1177\/0961203309104392"},{"key":"2025082723233057000_16.1.e253096.19","doi-asserted-by":"publisher","DOI":"10.1177\/0961203313502571"},{"key":"2025082723233057000_16.1.e253096.20","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-019-7378-9","article-title":"What is needed in culturally competent healthcare systems? A qualitative exploration of culturally diverse patients and professional interpreters in an Australian healthcare setting","volume":"19","author":"White","year":"2019","journal-title":"BMC Public Health"},{"key":"2025082723233057000_16.1.e253096.21","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-018-3001-5","article-title":"Health workforce cultural competency interventions: a systematic scoping review","volume":"18","author":"Jongen","year":"2018","journal-title":"BMC Health Serv Res"},{"key":"2025082723233057000_16.1.e253096.22","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1177\/0961203320909150","article-title":"Sudden visual loss in a patient with systemic lupus erythematosus caused by a combination of the disease itself and drug toxicity","volume":"29","author":"Lee","year":"2020","journal-title":"Lupus"},{"key":"2025082723233057000_16.1.e253096.23","doi-asserted-by":"publisher","DOI":"10.1097\/00041327-200109000-00006"},{"key":"2025082723233057000_16.1.e253096.24","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1097\/RHU.0000000000000576","article-title":"Cortical blindness in systemic lupus erythematosus: the blind wolf","volume":"23","author":"Khan","year":"2017","journal-title":"J Clin Rheumatol"},{"key":"2025082723233057000_16.1.e253096.25","doi-asserted-by":"publisher","DOI":"10.1177\/0961203307085405"},{"key":"2025082723233057000_16.1.e253096.26","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1111\/j.1442-9071.2009.02088.x","article-title":"Potentially blinding herbal eye remedies: cestrum nocturnum or lady of the night","volume":"37","author":"Altaie","year":"2009","journal-title":"Clin Exp Ophthalmol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-253096","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:23:41Z","timestamp":1756362221000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-253096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1,2]]},"published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1136\/bcr-2022-253096"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-253096","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]}}}