[系统性红斑狼疮中的纵向脊髓炎]
[Longitudinal myelitis in systemic lupus erythematosus].
作者信息
Perrin F, Espitia O, Ponge T, Mussini J-M, Hamidou M, Agard C
机构信息
Service de médecine interne, Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 01, France.
出版信息
Rev Med Interne. 2011 May;32(5):302-5. doi: 10.1016/j.revmed.2011.02.005. Epub 2011 Mar 9.
INTRODUCTION
Myelitis occurs in less than 5% of the patients during the disease course of systemic lupus erythematosus (SLE). Longitudinal myelitis, characterized by inflammatory involvement of at least four medullar segments, is a particular form of myelitis.
CASE REPORT
We report a 31-year-old woman with SLE, admitted for paraparesia and delirium. Lumbar puncture and MRI led to the diagnosis of longitudinal myelitis. The patient rapidly improved after corticosteroid therapy.
CONCLUSION
Transverse myelitis in SLE patients has been already commonly reported, but longitudinal myelitis is uncommon. Longitudinal myelitis has to be suspected in case of paraplegia or tetraplegia, with sensory defects and bladder dysfunction. MRI shows typically T2 medullar hypersignals. This may result in neurologic sequela. Cyclophosphamide has been used in patients where corticosteroids were inefficient.
引言
脊髓炎在系统性红斑狼疮（SLE）病程中的发生率低于5%。纵向脊髓炎是脊髓炎的一种特殊形式，其特征为至少四个髓节段出现炎症累及。
病例报告
我们报告一名31岁的SLE女性患者，因双下肢轻瘫和谵妄入院。腰椎穿刺和磁共振成像（MRI）检查确诊为纵向脊髓炎。患者在接受皮质类固醇治疗后迅速好转。
结论
SLE患者的横贯性脊髓炎已被普遍报道，但纵向脊髓炎并不常见。出现截瘫或四肢瘫并伴有感觉缺陷和膀胱功能障碍时，应怀疑纵向脊髓炎。MRI通常显示髓节段T2高信号。这可能导致神经后遗症。对于皮质类固醇治疗无效的患者，已使用环磷酰胺进行治疗。
Zotero 插件