Systemic Lupus Erythematosus,Thrombotic Microangiopathy,and Purtscher-Like Retinopathy in a Patient Who Experienced Resolution With Eculizumab Treatment: A Case Report
Restricted accessCase reportFirst published online February, 2026
Systemic Lupus Erythematosus,Thrombotic Microangiopathy,and Purtscher-Like Retinopathy in a Patient Who Experienced Resolution With Eculizumab Treatment: A Case Report
AlahmadiRMHashimRTAlmogairinSMAlAsrarAMA. Purtscher-like retinopathy as a first presentation of systematic lupus erythematosus. Ann Saudi Med. 2016;36:85–88.
2.
ÁlvarezJFSSerret CampsAAguayo AlvarezJGarcía GarcíaO.Optic coherence tomography angiography follow-up in a case of Purtscher-like retinopathy due to atypical hemolytic uremic syndrome. Eur J Ophthalmol. 2020;30(3):NP14–NP17. https://doi.org/10.1177/1120672119833277.
3.
Behrens-BaumannWScheurerGSchroerH.Pathogenesis of Purtscher’s retinopathy. An experimental study. Graefes Arch Clin Exp Ophthalmol. 1992;230(3):286–291. https://doi.org/10.1007/BF00176306.
4.
CohenDKoopmansMHovingaICLK, et al. Potential for glomerular C4d as an indicator of thrombotic microangiopathy in lupus nephritis. Arthritis Rheum. 2008;58:2460–2469.
5.
CouturePHiéMde ChambrunMP, et al. FRI0302 Systemic lupus erythematosus-associated thrombotic microangiopathies in 60 patients: clinical features, prognosis and treatment in a French multicentric cohort. Ann Rheum Dis. 2018;77(2):688–689.
6.
CunninghamETTabbaraKFZierhutM.Systemic lupus erythematosus and the eye. Ocul Immunol Inflamm. 2018;26(8):1143–1145.
7.
de CarvalhoJERSchlingemannROOranjeMBemelmanFJvan SchooneveldMJ.Reversal of threatening blindness after initiation of eculizumab in Purtscher-like retinopathy secondary to atypical hemolytic uremic syndrome. Int Ophthalmol. 2018;38:399–407.
FanouriakisAKostopoulouMAndersenJ, et al. EULAR recommendations for the management of systemic lupus erythematosus: 2023 update. Ann Rheum Dis. 2024;83(1):15–29.
10.
GangeWSHaghighiAToyBC.Purtscher-like retinopathy associated with atypical hemolytic uremic syndrome: case report and review of outcomes. Retin Cases Brief Rep. 2023;17(2):154–159.
KelloNEl KhouryLMarderGFurieRZapantisEHorowitzDL.Secondary thrombotic microangiopathy in systemic lupus erythematosus and antiphospholipid syndrome, the role of complement and use of eculizumab: case series and review of literature. Semin Arthritis Rheum. 2019;49:74–83.
13.
LiMJinYHeJ.Purtscher-like retinopathy associated with systemic lupus erythematosus treated with rituximab plus low-dose interleukin-2: a case report. Int J Rheum Dis. 2023;26:1373–1376.
14.
Mejía-TurizoJCDurán-MerinoCEGómez-RodríguezPAVanegas-RamírezCM.Purtscher-like retinopathy with bilateral vasculitis and vascular occlusion as the first manifestation of systemic lupus erythematosus. A case report. Revista Colombiana de Reumatología (English Edition). 2023;30(2):156–161. https://doi.org/10.1016/j.rcreue.2021.05.011.
15.
PalmaLMPSridharanMSethiS. Complement in secondary thrombotic microangiopathy. Kidney Int Rep. 2021;6(1):11–23.
16.
ScheurerGPraetoriusGDamerauBBaumannWB. Vascular occlusion of the retina: an experimental model: I. Leukocyte aggregates. Graefes Arch Clin Exp Ophthalmol. 1992;230:275–280.
17.
SerhanHAAbuawwadMTTahaMJJ, et al. Purtscher’s and Purtscher-like retinopathy etiology, features, management, and outcomes: a summative systematic review of 168 cases. PLoS ONE. 2024;19(9):e0306473.
18.
UstaoğluMÖnderFSolmazNÖztürkSAyerM.Purtscher-like retinopathy associated with atypical hemolytic uremic syndrome. Turk J Ophthalmol. 2017;47(6):348.
19.
ViletJMMRuizIAGCruzC, et al. Alternative complement pathway activation in thrombotic microangiopathy associated with lupus nephritis. Clin Rheumatol. 2021;40(6):2233–2242.
20.
WrightRDBannermanFBeresfordMWOniL.A systematic review of the role of eculizumab in systemic lupus erythematosus-associated thrombotic microangiopathy. BMC Nephrol. 2020;21(1):245–252. https://doi.org/10.1186/s12882-020-01888-5.
21.
WuCDaiRDongFWangQ.Purtscher-like retinopathy in systemic lupus erythematosus. Am J Opthalmol. 2014;158:1335–1341.
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