High anti-double-stranded DNA antibodies and progressive multifocal leukoencephalopathy in a patient with systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is an autoimmune disease with protean manifestations and an unpredictable course. Treatment is determined mainly by the extent of disease manifestations. Severe systemic, renal or neurological impairment may necessitate longterm immunosuppressive therapy. The clinical management of lupus patients is challenging. During its early course, it may be difficult to make the diagnosis of SLE. During its later course, it remains difficult to differentiate disease progression or relapse from treatment complications or opportunistic infections.