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[白塞病中与环孢素相关的脑肿瘤样病变部位]

[Ciclosporin-associated cerebral tumor-like location of Behçet's disease].

作者信息

Bouomrani S, Hammami S, Braham R, Mahjoub S

机构信息

Services de Médecine Interne, Hôpital Universitaire Fattouma Bourguiba, Monastir 5000, Tunisie.

出版信息

Rev Neurol (Paris). 2010 Oct;166(10):849-54. doi: 10.1016/j.neurol.2010.01.010. Epub 2010 Mar 25.

Abstract

INTRODUCTION

Cerebral tumor-like location is uncommon in the course of Behçet's disease. We report herein a patient with tumor-like lesions associated with ciclosporin therapy.

CASE REPORT

A 45-year-old male treated for 17 years with colchicine and ciclosporin for Behçet's disease with cutaneomucosal, ocular and joint involvement was admitted for sudden onset of meningo-encephalitis with lymphocytic meningitis. CT-scan showed a nodular lesion of the brainstem enhanced by iodine. Ciclosporin was discontinued; prednisone and IV cyclophosphamide were started. After three months of favorable outcome, a relapse occurred when ciclosporin was started again. MRI showed two additional capsulothalamic lesions. Prednisone and cyclophosphamide were started again with a favorable response and minimal sequelae.

CONCLUSION

The main challenge in cerebral tumor-like location of Behçet's disease is to rule out other inflammatory or tumor processes. Neuronal toxicity of ciclosporin limits indications for this therapy in Behçet's disease.

摘要

引言

在白塞病病程中,脑肿瘤样定位并不常见。我们在此报告一例与环孢素治疗相关的肿瘤样病变患者。

病例报告

一名45岁男性,因皮肤黏膜、眼部和关节受累,接受秋水仙碱和环孢素治疗白塞病17年,因突发淋巴细胞性脑膜炎伴脑膜脑炎入院。CT扫描显示脑干有一个碘增强的结节性病变。停用环孢素;开始使用泼尼松和静脉注射环磷酰胺。经过三个月的良好疗效后,再次开始使用环孢素时病情复发。MRI显示另外两个丘脑囊病变。再次开始使用泼尼松和环磷酰胺,反应良好且后遗症轻微。

结论

白塞病脑肿瘤样定位的主要挑战是排除其他炎症或肿瘤性病变。环孢素的神经毒性限制了其在白塞病治疗中的应用指征。

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