{"title":"Bilateral Serous Retinal Detachment as an Initial Manifestation of Systemic Lupus Erythematosus due to Hypoalbuminemia: A Case Report.","authors":"Zikang Xu, Anyi Liang, Dan Cao, Liang Zhang","doi":"10.1159/000543005","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>There are diverse etiologies of serous retinal detachment (SRD), and hypoalbuminemia is one of the rare causes of it. We report a case of bilateral SRD attributed to decreased serum albumin level caused by systemic lupus erythematosus (SLE).</p><p><strong>Case presentation: </strong>A 28-year-old female with no significant past medical history presented with bilateral palpebral edema for 10 days and blurred vision for 3 days. Optical coherence tomography demonstrated subretinal fluid in both eyes; fluorescein angiography revealed multiple hyperfluorescent spots with late leakage and pooling. Extensive serological and systemic examinations showed a slight decrease in serum albumin level with no other notable abnormalities. With the suspected diagnosis of Vogt-Koyanagi-Harada disease, the patient received high-dose intravenous corticosteroid therapy without any improvement. However, significant clinical improvement was achieved after albumin supplementation and corticosteroid dose tapering. The decrease in albumin levels in this patient was ultimately found to be due to protein-losing enteropathy (PLE) caused by SLE.</p><p><strong>Conclusions: </strong>This case presented a rare cause of bilateral SRD associated with hypoalbuminemia induced by SLE-related PLE. The report revealed that ocular involvements such as palpebral edema and SRD can be the initial manifestations of SLE rather than common lupus retinopathy. It emphasized the values of ocular manifestations as a clue for prompt diagnosis and management of systemic conditions.</p>","PeriodicalId":9635,"journal":{"name":"Case Reports in Ophthalmology","volume":"16 1","pages":"48-56"},"PeriodicalIF":0.5000,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842062/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Ophthalmology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000543005","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
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Abstract
Introduction: There are diverse etiologies of serous retinal detachment (SRD), and hypoalbuminemia is one of the rare causes of it. We report a case of bilateral SRD attributed to decreased serum albumin level caused by systemic lupus erythematosus (SLE).
Case presentation: A 28-year-old female with no significant past medical history presented with bilateral palpebral edema for 10 days and blurred vision for 3 days. Optical coherence tomography demonstrated subretinal fluid in both eyes; fluorescein angiography revealed multiple hyperfluorescent spots with late leakage and pooling. Extensive serological and systemic examinations showed a slight decrease in serum albumin level with no other notable abnormalities. With the suspected diagnosis of Vogt-Koyanagi-Harada disease, the patient received high-dose intravenous corticosteroid therapy without any improvement. However, significant clinical improvement was achieved after albumin supplementation and corticosteroid dose tapering. The decrease in albumin levels in this patient was ultimately found to be due to protein-losing enteropathy (PLE) caused by SLE.
Conclusions: This case presented a rare cause of bilateral SRD associated with hypoalbuminemia induced by SLE-related PLE. The report revealed that ocular involvements such as palpebral edema and SRD can be the initial manifestations of SLE rather than common lupus retinopathy. It emphasized the values of ocular manifestations as a clue for prompt diagnosis and management of systemic conditions.
期刊介绍：
This peer-reviewed online-only journal publishes original case reports covering the entire spectrum of ophthalmology, including prevention, diagnosis, treatment, toxicities of therapy, supportive care, quality-of-life, and survivorship issues. The submission of negative results is strongly encouraged. The journal will also accept case reports dealing with the use of novel technologies, both in the arena of diagnosis and treatment. Supplementary material is welcomed. The intent of the journal is to provide clinicians and researchers with a tool to disseminate their personal experiences to a wider public as well as to review interesting cases encountered by colleagues all over the world. Universally used terms can be searched across the entire growing collection of case reports, further facilitating the retrieval of specific information. Following the open access principle, the entire contents can be retrieved at no charge, guaranteeing easy access to this valuable source of anecdotal information at all times.
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