{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:09:35Z","timestamp":1787018975032,"version":"build-2736575974"},"reference-count":31,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T00:00:00Z","timestamp":1685664000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Neuropsychiatric manifestations in systemic lupus erythematosus (SLE) occur in about half of the patients; however, movement disorders like Parkinsonism are rare. We describe a case of SLE who presented solely with features of Parkinsonism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report<\/jats:title>\n                    <jats:p>50-year-old female presented with global slowing of movements and slowing of speech since 2\u00a0months. On examination, she had mask-like facies with a faint malar rash sparing the nasolabial folds, hard palate ulcer, cog-wheel rigidity, and proximal muscle weakness. Lab evaluation revealed lymphopenia, high ESR, elevated lactate dehydrogenase, creatinine phosphokinase, AST, and ALT levels. She had high anti-dsDNA levels with low complements. Urinalysis showed proteinuria and hematuria. ANA was positive at a titer of 1:320, and she had positive anti-ribosomal-P antibody. She had severe flare with a SLEDAI of 33. She was treated with pulse IV methylprednisolone followed by cyclophosphamide (NIH protocol). At 4\u00a0weeks follow-up, she had dramatic improvement in her Parkinsonian symptoms and her proximal muscle weakness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The prevalence of movement disorders in cases of neuropsychiatric SLE is very low at 0.7%, with chorea being most frequent and Parkinsonism rare. The pathogenesis is multifactorial including anti-dopaminergic antibodies or associated anti-phospholipids causing microvascular thrombosis or vasculitis of the thalamostriatal arteries or disease activity itself. As in our case, immunosuppression and optimal treatment of active lupus reverts symptoms in most cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A high index of suspicion needs to be exercised in cases of SLE presenting with Parkinsonism as adequate immunosuppression translates to near-complete recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09612033231181636","type":"journal-article","created":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T09:39:45Z","timestamp":1685698785000},"page":"1001-1007","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Parkinsonism as the presenting manifestation of lupus: A case-based review"],"prefix":"10.1177","volume":"32","author":[{"given":"Prakashini","family":"MV","sequence":"first","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debashis","family":"Maikap","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasanta","family":"Padhan","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,6,2]]},"reference":[{"key":"bibr1-09612033231181636","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25011"},{"key":"bibr2-09612033231181636","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-013-1023-z"},{"key":"bibr3-09612033231181636","doi-asserted-by":"publisher","DOI":"10.1002\/art.40764"},{"key":"bibr4-09612033231181636","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2010.08.001"},{"key":"bibr5-09612033231181636","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.17969"},{"key":"bibr6-09612033231181636","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kep346"},{"key":"bibr7-09612033231181636","doi-asserted-by":"publisher","DOI":"10.1002\/art.22672"},{"key":"bibr8-09612033231181636","volume-title":"International Review of Neurobiology","author":"Barba C","year":"2019"},{"key":"bibr9-09612033231181636","doi-asserted-by":"publisher","DOI":"10.1053\/berh.2001.0223"},{"key":"bibr10-09612033231181636","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2012.03.010"},{"key":"bibr11-09612033231181636","unstructured":"Chemaly RE, Moussalli AS. 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