Subarachnoid Hemorrhage in Autoimmune Vasculitis: A Rare Study of SLE-Anca Vasculitis Overlap Syndrome

Abstract

This case study wants to highlight the importance of taking SLE-AAV overlap into account in patients who have symptoms that are similar to those in the case report and to underscore the importance of making an early diagnosis because a delayed diagnosis can be fatal. Systemic lupus erythematosus (SLE) and antineutrophil cytoplasmic autoantibodies (ANCA)-associated vasculitis (AAV) differ from one another while having comparable clinical characteristics. It is uncommon for SLE and AAV to co-occur as overlapping conditions, which makes diagnosis challenging. Here, we present an unusual combination of hemorrhagic stroke, SLE, and AAV that has only ever been documented once. Multiple positive autoantibodies complicated the diagnosis, but a kidney biopsy revealed the true cause and assisted at the beginning of immunosuppressive medication. Standard early surgical measures to lower excessive intracranial pressure were unsuccessful for the patient, but she significantly improved after starting immunosuppressive medication, demonstrating a temporal connection.