摘要
To the Editor,Systemic lupus erythematosus(SLE)is a chronic autoimmune systemic disease in which the immune system attacks healthy cells and tissues throughout the body with a broad variety of clinical manifestations,and is more prevalent in African American women and women than in other ethnic minority groups.1 The maximum estimation for the prevalence of SLE in the United States is about 320,000 patients.2 However,the first presentation of SLE often mimics a viral syndrome with constitutional symptoms,like,a low-grade fever,fatigue,and weight loss,and maybe arthralgia or arthritis;it may present in several other ways and have an abrupt onset with target-organ involvement,particularly in Hispanics(61%)and African Americans(45%)compared with Whites(41%).1 Neurological manifestations are common in SLE,named neuropsychiatric SLE,and its prevalence ranges between 14%and 95%,which is more common in children than adults.The involvement of the nervous system is coupled with worse outcomes and mortality rates vary from 2%to 45%.Psychoses,seizures,and cranial nerve involvement,in particular,have been given much emphasis.Besides,visual defects secondary to involvement of the visual pathways posterior to the optic chiasm,presenting as homonymous hemianopia,were rarely reported in SLE.3-5 On the other hand,homonymous hemianopia as the first manifestation of SLE is extremely rare in the literature.In this paper,we present a patient who experienced homonymous hemianopia as the initial presentation of SLE.
