Phoenix Children’s Neurologists Tara Mangum, DO, Kavitha T. Karnik, MD, and Alireza Tavasoli, MD, et. al., are co-authors of a peer-reviewed case report describing a rare and severe presentation of pediatric neuropsychiatric systemic lupus erythematosus (NP-SLE) involving simultaneous acute cerebellitis and bilateral thalamic involvement.

Kavitha T. Karnik, MD

The report details a 13-year-old patient with newly diagnosed SLE who developed neuropsychiatric SLE (NP-SLE) – presenting with acute cerebellar dysfunction, impaired consciousness and nonconvulsive status epilepticus – despite initially atypical neuroimaging. Advanced MRI revealed cerebellar cortical diffusion restriction with concurrent bilateral thalamic signal abnormalities consistent with vasogenic edema, without vascular occlusion – findings that expand the recognized imaging spectrum of pediatric NP-SLE.

This case underscores the importance of distinguishing inflammatory NP-SLE from mimics such as posterior reversible encephalopathy syndrome, infection or ischemia, as management and prognosis differ substantially. The patient required early multimodal therapy, including high-dose corticosteroids, antiseizure treatment, plasmapheresis, cyclophosphamide and rituximab, followed by rehabilitation and maintenance therapy, ultimately achieving gradual neurologic recovery. Read the Case Report

Phoenix Children's Neuroimmunology Program accepts referrals for children with neuroimmune conditions, including pediatric neuropsychiatric lupus and other autoimmune neurological disorders. To refer a patient or request a consultation, call 602-933-KIDS (5437) or submit a referral online.

REFERENCE

Anderson J, et al. Concurrent Thalamic and Cerebellar Involvement in Pediatric Neuropsychiatric Lupus: Expanding the Radiologic Spectrum. Lupus. 2026. PubMed ID 41674410.