Watanabe Toru, Onda Hiroo
Department of Pediatrics, Niigata City General Hospital, 2-6-1 Shichikuyama, Niigata 950-8739, Japan.
Pediatr Nephrol. 2004 Apr;19(4):451-3. doi: 10.1007/s00467-003-1388-6. Epub 2004 Jan 23.
Although central nervous system involvement is an important manifestation of systemic lupus erythematosus (SLE), chorea is a relatively uncommon complication. A strong association between chorea and the presence of antiphospholipid antibodies (aPLs) has been reported in patients with SLE, lupus-like disease, or primary antiphospholipid syndrome. We describe a patient with lupus nephritis and cerebral infarction, who subsequently developed recurrent hemichorea associated with increased aPLs levels. A 7-year-old boy suffered from lupus nephritis and a left middle cerebral artery infarction associated with aPLs. He subsequently experienced two episodes of right hemichorea associated with increased aPLs levels without any evidence of further neurological lesions by brain computed tomography or magnetic resonance imaging. The previous left cerebral artery infarction might have increased the susceptibility of the left basal ganglia to the effects of aPLs that contributed to the development of the right hemichorea in this patient.
虽然中枢神经系统受累是系统性红斑狼疮（SLE）的重要表现，但舞蹈症是一种相对罕见的并发症。在SLE、狼疮样疾病或原发性抗磷脂综合征患者中，已有报道舞蹈症与抗磷脂抗体（aPLs）的存在之间存在密切关联。我们描述了一名患有狼疮性肾炎和脑梗死的患者，该患者随后出现了与aPLs水平升高相关的反复偏侧舞蹈症。一名7岁男孩患有狼疮性肾炎和与aPLs相关的左侧大脑中动脉梗死。他随后经历了两次右侧偏侧舞蹈症发作，发作时aPLs水平升高，而脑部计算机断层扫描或磁共振成像未显示任何进一步神经病变的证据。先前的左侧脑动脉梗死可能增加了左侧基底节对aPLs作用的易感性，这促成了该患者右侧偏侧舞蹈症的发生。
