Alexa Ioana Dana, Stoica Mihaela Simona, Paraschiv Oana, Rusu R I
Universitatea de Medicină Si Farmacie Gr. T. Popa Iaşi, Facultatea de Medicină, Clinica IV Medicală-Nefrologie.
Rev Med Chir Soc Med Nat Iasi. 2006 Apr-Jun;110(2):322-5.
Neuropsychiatric systemic lupus erythematosus (NPSLE) has become a popular term designing all neurological and psychiatric complications in patients with systemic lupus erythematosus (SLE). It occurs in up to two thirds of all SLE patients and it covers a vast array of disorders ranging from peripheral neuropathy to stroke, psychosis, and dementia. Mechanisms associated with the pathogenesis of NPSLE include anti-neuronal antibodies, antiphospholipid antibody associated thrombosis, emboli from cardiac source and, rarely, vasculitis by immune complex depositions. Although the most common manifestations is cognitive dysfunction (50%), NPSLE may also present itself as peripheral neuropathy (15%), psychosis (10%), or other central nervous system abnormalities (stroke, organic brain syndrome, seizures). In lupus patients, one should always look for secondary causes of the neuropsychiatric manifestation, including infection, toxic metabolic abnormalities, and hypertension. We present two cases of SLE, which developed neuropsychiatric manifestations.
神经精神性系统性红斑狼疮(NPSLE)已成为一个常用术语,用于描述系统性红斑狼疮(SLE)患者出现的所有神经和精神并发症。它在所有SLE患者中发生率高达三分之二,涵盖了从周围神经病变到中风、精神病和痴呆等一系列广泛的疾病。与NPSLE发病机制相关的因素包括抗神经元抗体、抗磷脂抗体相关的血栓形成、心脏来源的栓子,以及罕见的免疫复合物沉积引起的血管炎。尽管最常见的表现是认知功能障碍(50%),但NPSLE也可能表现为周围神经病变(15%)、精神病(10%)或其他中枢神经系统异常(中风、器质性脑综合征、癫痫发作)。对于狼疮患者,应始终寻找神经精神表现的继发原因,包括感染、毒性代谢异常和高血压。我们报告了两例出现神经精神表现的SLE病例。