Reumatología Pediátrica, Hospital Infantil de México Federico Gómez, Mexico, Mexico.
Rheumatol Int. 2010 May;30(7):965-8. doi: 10.1007/s00296-009-1008-2. Epub 2009 Jun 18.
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired, autoimmune peripheral neuropathy. Systemic lupus erythematosus (SLE) is a multisystemic, autoimmune disease that can affect the central nervous system in about 40% of patients, with prevalence and incidence unknown in the pediatric population due to lack of multicenter studies. We report the case of a 13-year-old Mexican boy, diagnosed with CIDP at the onset of SLE, beginning with progressive muscle weakness of lower and upper limbs, without affection of the central nervous system. The patient had positive ANA, antiDNAdc, antiBeta2glycoprotein, anti-cardiolipin, ANCA-C and X. He received intravenous immunoglobulin, cyclophosphamide, steroids, and azathioprine and showed clinical improvement. It is important to take into account the presence of peripheral neurological disorders in patients with pediatric SLE, considering CIDP as an uncommon presentation, making the diagnosis important for better treatment and evolution.
慢性炎症性脱髓鞘性多发性神经病(CIDP)是一种获得性自身免疫性周围神经病。系统性红斑狼疮(SLE)是一种多系统自身免疫性疾病,约 40%的患者会影响中枢神经系统,由于缺乏多中心研究,儿科人群的患病率和发病率尚不清楚。我们报告了一例 13 岁的墨西哥男孩,在 SLE 发病时被诊断为 CIDP,最初表现为下肢和上肢进行性肌无力,无中枢神经系统受累。该患者的 ANA、抗 DNAdc、抗β2糖蛋白、抗心磷脂、anca-c 和 X 均为阳性。他接受了静脉注射免疫球蛋白、环磷酰胺、类固醇和硫唑嘌呤治疗,临床症状有所改善。重要的是要考虑到儿科 SLE 患者存在周围神经障碍,因为 CIDP 是一种不常见的表现,因此对更好的治疗和预后进行诊断很重要。