Presentation of Case A 60-year-old woman was admitted to the hospital after two seizures. The patient was well until 1 1/2 years earlier, when arthralgia developed and she consulted a rheumatologist. The erythrocyte sedimentation rate was 74 mm per hour; a test for antinuclear antibodies was positive in a titer of 1:128, with a homogeneous pattern; a test for antinative DNA antibodies was negative. A presumptive diagnosis of systemic lupus erythematosus was made, and hydroxychloroquine and ibuprofen were prescribed, with partial relief of her symptoms. An ophthalmologist later found evidence of early pigmentary maculopathy, and hydroxychloroquine was discontinued. A repeated.
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