Sridhar A V, Gosalakkal J, Pye I F, Houtman P
Department of Paediatrics, Leicester Royal Infirmary, University Hospitals of Leicester NHS trust, Leicester LEI 5WW, UK.
Eur J Paediatr Neurol. 2004;8(5):253-6. doi: 10.1016/j.ejpn.2004.04.004.
Peripheral neuropathy is an uncommon complication in paediatric systemic lupus erythematosus (SLE). We report the case of a 10-year-old Chinese girl who developed peripheral neuropathy within 3 months of the onset of SLE and presented with bilateral foot drop and sensory symptoms of both hands and feet. There was no involvement of the central nervous system at the time of presentation. The patient was negative for anticardiolipin antibodies, but positive for lupus anticoagulant. She was treated with intravenous methylprednisolone followed by oral steroids, methotrexate, gabapentin and amitryptyline. Although peripheral neuropathy is a rare complication of paediatric systemic lupus erythematosus, one should be vigilant for this entity as part of the neurological spectrum. It may not be associated with involvement of the central nervous system. Antiphospholipid antibodies may have role in the pathogenesis of SLE associated peripheral neuropathy. We speculate that routine nerve conduction studies may have a role in detecting sub-clinical cases.
周围神经病变是儿童系统性红斑狼疮(SLE)中一种不常见的并发症。我们报告了一例10岁中国女孩的病例,该女孩在SLE发病后3个月内出现周围神经病变,表现为双侧足下垂以及双手和双足的感觉症状。就诊时中枢神经系统未受累。该患者抗心磷脂抗体阴性,但狼疮抗凝物阳性。她接受了静脉注射甲泼尼龙治疗,随后口服类固醇、甲氨蝶呤、加巴喷丁和阿米替林。尽管周围神经病变是儿童系统性红斑狼疮的一种罕见并发症,但作为神经谱系的一部分,对此应保持警惕。它可能与中枢神经系统受累无关。抗磷脂抗体可能在SLE相关周围神经病变的发病机制中起作用。我们推测常规神经传导研究可能在检测亚临床病例方面发挥作用。