Cardona-Portela P, Casasnovas-Pons C, Moral-Torres M, Rubio-Borrego F
Servicio de Neurología, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
Rev Neurol. 2004;39(1):30-4.
Cerebral venous thrombosis (CVT) is an infrequent process in systemic lupus erythematosus. We report the case of a female patient whose initial manifestation of lupus was a CVT.
A 30-year-old female who presented headaches and diminished visual acuity; on exploring the patient bilateral papilloedema was found. Magnetic resonance imaging revealed the presence of a venous thrombosis in the superior and transversal longitudinal sinus. Complementary explorations showed high levels of antinuclear antibodies with leukopenia and proteinuria. Antiphospholipid antibodies were negative. Following treatment with anticoagulants, the patient's condition improved both clinically and radiologically. Months later a biopsy was performed and revealed a grade IV diffuse glomerulonephritis.
In systemic lupus erythematosus, phenomena such as CVT can be the initial form of presentation of the disease. The presence of antiphospholipid antibodies plays a partial role in CVT; other phenomena, such as inflammatory processes, should also be taken into account.
脑静脉血栓形成(CVT)在系统性红斑狼疮中是一种不常见的病症。我们报告了一例女性患者,其狼疮的最初表现为CVT。
一名30岁女性,出现头痛和视力下降;检查发现患者双侧视乳头水肿。磁共振成像显示上矢状窦和横窦存在静脉血栓形成。进一步检查显示抗核抗体水平升高,伴有白细胞减少和蛋白尿。抗磷脂抗体为阴性。经抗凝治疗后,患者的临床和影像学状况均有所改善。数月后进行活检,结果显示为IV级弥漫性肾小球肾炎。
在系统性红斑狼疮中,CVT等现象可能是该疾病的初始表现形式。抗磷脂抗体的存在在CVT中起部分作用;还应考虑其他现象,如炎症过程。