Vermeulen M, Huizinga T W J
Universiteit van Amsterdam, afd. Neurologie, Postbus 22.660, 1100 DD Amsterdam.
Ned Tijdschr Geneeskd. 2006 Feb 18;150(7):367-72.
The nomenclature of the American College of Rheumatology leads to misunderstandings in multidisciplinary discussions on patients with systemic lupus erythematosus (SLE) who also have neurological or psychiatric symptoms. These proposed neuropsychiatric syndromes are rarely syndromes and the symptoms are rarely neuropsychiatric. It is better first of all to determine whether the SLE patients have neurological or psychiatric symptoms, and if these symptoms are present, the first question is what is the cause. Vasculitis of the cerebral blood vessels should be considered as a possible explanation only if ischaemic lesions in the brain have been demonstrated, other causes of cerebral ischaemia in SLE are unlikely, and the clinical signs are consistent with cerebral vasculitis. These other causes of cerebral ischaemia include: antiphospholipid antibodies, atherosclerosis, heart valve disorders and thrombotic thrombocytopenic purpura.
美国风湿病学会的命名法在关于同时患有神经或精神症状的系统性红斑狼疮（SLE）患者的多学科讨论中会导致误解。这些提出的神经精神综合征很少是真正的综合征，而且症状很少是神经精神性的。首先最好确定SLE患者是否有神经或精神症状，如果存在这些症状，首要问题是病因是什么。仅当脑缺血性病变已被证实、SLE中脑缺血的其他原因不太可能且临床体征与脑血管炎一致时，才应考虑脑血管炎作为一种可能的解释。这些脑缺血的其他原因包括：抗磷脂抗体、动脉粥样硬化、心脏瓣膜疾病和血栓性血小板减少性紫癜。
