Imanaka H, Takei S, Hukami S, Maeno N, Shigemori M, Hokonohara M, Miyata K
Department of Pediatrics, Faculty of Medicine, Kagoshima University, Kagoshima-city.
Ryumachi. 1999 Feb;39(1):22-6.
An eleven-year-old boy with systemic lupus erythematosus (SLE) developed severe bilateral lupus retinopathy when he was in active stage of SLE. The patient, who had suffered from SLE for 3 years, was admitted to our hospital because of high grade fever, systemic lymphadenopathy, leukopenia, elevation of erythrocyte sedimentation rate and hypocomplementemia. The dose of prednisolone was increased considering he was exacerbated of SLE, however, the convulsion as CNS lupus occurred to him. After the event he noted loss of vision in his bilateral eyes. The ophthalmologic examination revealed the lesions of cotton-wool spots, retinal vessel dilatations and diffuse occlusions of the retinal arterioles and venules which were compatible with lupus retinopathy. Although the coagulation time was normal, antiphospholipid antibodies were positive at the time of ocular involvement. Careful attention should be paid to the occurrence of lupus retinopathy when the patients with SLE developed in the active stage or CNS lupus, especially they have antiphospholipid antibodies.
一名11岁的系统性红斑狼疮(SLE)男孩在SLE活动期出现了严重的双侧狼疮性视网膜病变。该患者患SLE已3年,因高热、全身淋巴结肿大、白细胞减少、红细胞沉降率升高和补体减少而入住我院。考虑到他的SLE病情加重,增加了泼尼松龙的剂量,然而,他发生了中枢神经系统狼疮性惊厥。此后,他注意到双眼视力丧失。眼科检查发现棉絮斑、视网膜血管扩张以及视网膜小动脉和小静脉弥漫性闭塞等病变,这些与狼疮性视网膜病变相符。尽管凝血时间正常,但在眼部受累时抗磷脂抗体呈阳性。当SLE患者处于活动期或发生中枢神经系统狼疮时,尤其是存在抗磷脂抗体时,应密切关注狼疮性视网膜病变的发生。