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混合性结缔组织病合并疱疹病毒感染所致脑膜炎:病例报告

Meningitis in mixed connective tissue disease complicated by herpes virus infection: case report.

作者信息

Bodolay Edit, Diószeghy Péter, Demeter József, Bányai Anikó, Csipö István, Szegedi Gyula, Szekanecz Zoltán

机构信息

Division of Clinical Immunology, Third Department of Internal Medicine, University of Debrecen Medical and Health Science Center, 4004 Debrecen, Móricz Zs. 22., Hungary.

出版信息

Rheumatol Int. 2004 Nov;24(6):359-61. doi: 10.1007/s00296-004-0440-6. Epub 2004 Feb 18.

Abstract

The authors report a rare case of a female patient diagnosed with mixed connective tissue disease (MCTD). After a few years in remission, the patient acquired herpes zoster infection followed by a disease flare. Disease activity was accompanied by the development of meningitis. To determine whether the meningitis was caused by the previous herpes virus infection or was aseptic meningitis associated with the activity of MCTD raised important differential diagnostic issues. Repeated laboratory assessments of the patient's sera and cerebrospinal fluid revealed leukocytopenia, high anti-U1 ribonucleoprotein autoantibody level, increased immune complex, and decreased complement concentrations. The administration of corticosteroids resulted in rapid improvements in clinical symptoms and laboratory indicators.

摘要

作者报告了一例罕见的女性患者,该患者被诊断为混合性结缔组织病(MCTD)。在缓解数年之后,患者感染了带状疱疹,随后病情复发。疾病活动伴有脑膜炎的发生。确定脑膜炎是由先前的疱疹病毒感染引起还是与MCTD活动相关的无菌性脑膜炎引发了重要的鉴别诊断问题。对患者血清和脑脊液进行的反复实验室评估显示白细胞减少、抗U1核糖核蛋白自身抗体水平升高、免疫复合物增加以及补体浓度降低。给予皮质类固醇后,临床症状和实验室指标迅速改善。

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