Lee S I, Jeon H S, Yoo W H
Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine, Chonbuk, Korea.
Rheumatol Int. 2004 Sep;24(5):305-8. doi: 10.1007/s00296-003-0405-1. Epub 2004 Feb 28.
Dementia is a very rare neurological manifestation of systemic lupus erythematosus (SLE) and has a deep link with antiphospholipid antibodies (APL) and cerebral infarction in its development. However, nonvascular dementia irrelevant to APL or cerebral infarction has not been reported in patients with SLE until now. We describe a case of reversible dementia in an SLE patient without APL or cerebral infarction which was successfully treated with corticosteroid and cyclophosphamide. There are two significant points in this case. One is that humoral factors other than APL might be involved in the development of dementia. Secondly, reversible dementia without APL or cerebral infarction may respond more favorably to immunosuppressive therapy.
痴呆是系统性红斑狼疮（SLE）非常罕见的神经学表现，在其发病过程中与抗磷脂抗体（APL）及脑梗死有着密切联系。然而，迄今为止，尚未有SLE患者出现与APL或脑梗死无关的非血管性痴呆的报道。我们描述了1例无APL或脑梗死的SLE患者发生可逆性痴呆的病例，该患者经皮质类固醇和环磷酰胺治疗后痊愈。该病例有两点值得关注。一是APL以外的体液因素可能参与了痴呆的发病过程。二是无APL或脑梗死的可逆性痴呆可能对免疫抑制治疗反应更佳。
