Costello I, Phadke R, Shah N
Leicester Royal Infirmary, Leicester, UK.
J R Coll Physicians Edinb. 2011 Mar;41(1):22-5. doi: 10.4997/JRCPE.2011.106.
An immunocompromised patient with non-specific neurological symptoms and signs, along with rapid cognitive decline evolving over three to four weeks, can present a diagnostic challenge. Here we report rapidly progressive dementia in a patient with systemic lupus erythematosus, who was subsequently diagnosed with sporadic Creutzfeldt-Jakob disease (sCJD). This case illustrates the need for prompt investigations to consider an alternative diagnosis where significant history fails to yield an explanation. A diagnosis of sCJD drastically alters the prognosis in a subject with a well-controlled connective tissue disease who is otherwise fit and well.
一名免疫功能低下的患者出现非特异性神经症状和体征,同时在三到四周内出现快速认知衰退,这可能带来诊断挑战。在此,我们报告一例系统性红斑狼疮患者出现快速进展性痴呆,该患者随后被诊断为散发性克雅氏病(sCJD)。这个病例说明,当重要病史无法给出解释时,需要及时进行检查以考虑其他诊断。对于一名结缔组织病控制良好、身体状况原本良好的患者,sCJD的诊断会极大地改变其预后。