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Callosal Holes: An Unusual Imaging Appearance in Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) has diverse imaging features. However, focal lesions in the corpus callosum are extremely rare in SLE with only few cases mentioned in the literature, with no mention of callosal holes in SLE. Callosal holes have been described as a characteristic finding in Susac syndrome and have been mentioned in Nipah virus encephalitis, Marchiafava Bignami disease and periventricular leukomalacia. We describe a case of SLE with callosal holes. The demonstration of callosal holes in this case brings the imaging appearance of SLE a step closer to that of Susac syndrome which is considered a clinically and radiologically close condition. It also adds to the list of imaging appearances of central nervous system SLE.