Hung Jeng-Juh, Ou Liang-Shiou, Lee Wen-I, Huang Jing-Long
Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, Taoyuan, Taiwan.
J Rheumatol. 2005 Jan;32(1):40-3.
To evaluate the clinical profiles of patients with systemic lupus erythematosus (SLE) with central nervous system (CNS) infections.
We retrospectively reviewed patients with SLE with CNS infections from January 1983 to June 2003. The clinical features, laboratory data, and prognoses of these patients were recorded.
During the 20-year review period, 17 SLE patients with CNS infections were identified. The mean age at CNS infection was 29.6 +/- 15.3 years. Cryptococcal infection was identified in 10 patients and bacterial meningitis in 7. Most patients (94%) had active SLE at the time of CNS infection. Fifteen patients received corticosteroid therapy and of these, 7 received it in conjunction with immunosuppressive agents. The most common presentation was headache, fever, and vomiting. The mortality rate among the 17 patients was high (41.2%).
Cryptococcal meningitis played the major role in CNS infection of patients with SLE, and it cannot be ruled out even when the cerebrospinal fluid (CSF) white blood cell count is within normal range. CSF India ink and latex agglutination testing for cryptococcal antigen should be performed and are effective screening tools to establish an early diagnosis.
评估系统性红斑狼疮（SLE）合并中枢神经系统（CNS）感染患者的临床特征。
我们回顾性分析了1983年1月至2003年6月期间患有CNS感染的SLE患者。记录了这些患者的临床特征、实验室数据和预后情况。
在20年的回顾期内，共确定了17例患有CNS感染的SLE患者。发生CNS感染时的平均年龄为29.6±15.3岁。10例患者为隐球菌感染，7例为细菌性脑膜炎。大多数患者（94%）在发生CNS感染时SLE处于活动期。15例患者接受了皮质类固醇治疗，其中7例同时接受了免疫抑制剂治疗。最常见的表现为头痛、发热和呕吐。17例患者的死亡率较高（41.2%）。
隐球菌性脑膜炎在SLE患者的CNS感染中起主要作用，即使脑脊液（CSF）白细胞计数在正常范围内也不能排除。应进行CSF墨汁染色和隐球菌抗原乳胶凝集试验，它们是建立早期诊断的有效筛查工具。
