Ota Miho, Mizukami Katsuyoshi, Hayashi Taichi, Sumida Takayuki, Asada Takashi
Department of Psychiatry, Institute of Clinical Medicine, University of Tsukuba, Ibaraki 305-8575, Japan.
Prog Neuropsychopharmacol Biol Psychiatry. 2005 Feb;29(2):347-9. doi: 10.1016/j.pnpbp.2004.11.024. Epub 2005 Jan 8.
A 57-year-old female with relapsing polychondritis (RP) showing CNS complications is described with reference to the MRI and SPECT findings. At the age of 56, the patient was diagnosed with RP based on her symptoms, which included bilateral auricular chondritis, nonerosive seronegative inflammatory polyarthritis, and ocular inflammation, as well as vestibular dysfunction. During the course of the disease, she suffered from aseptic meningitis accompanied by delirium, which was resolved by treatment with cyclophosphamide, in addition to prednisolone concurrent with the improvement of her physical condition. After the meningitis improved, she developed a number of cognitive impairments, including time disorientation, agraphia, acalculia, constitutional apraxia, and personality changes. Simultaneously, we observed, via SPECT, a decrease in cerebral blood flow (CBF) in several regions, including the bilateral frontal, lateral temporal, and parietal regions. This is the first study to report on the CNS manifestations of RP with reference to MRI and SPECT findings.
本文结合MRI和SPECT检查结果，描述了一名57岁患有复发性多软骨炎（RP）并出现中枢神经系统并发症的女性患者。患者56岁时，根据其症状被诊断为RP，症状包括双侧耳廓软骨炎、非侵蚀性血清阴性炎性多关节炎、眼部炎症以及前庭功能障碍。在疾病过程中，她患有无菌性脑膜炎并伴有谵妄，除泼尼松龙外，经环磷酰胺治疗后病情得到缓解，同时身体状况有所改善。脑膜炎好转后，她出现了一些认知障碍，包括时间定向障碍、失写症、失算症、结构性失用症和性格改变。同时，我们通过SPECT观察到，包括双侧额叶、颞叶外侧和顶叶在内的多个区域脑血流量（CBF）减少。这是第一项结合MRI和SPECT检查结果报告RP中枢神经系统表现的研究。
