Matsuda Masayuki, Kishida Dai, Kinoshita Tomomi, Hineno Akiyo, Shimojima Yasuhiro, Fukushima Kazuhiro, Ikeda Shu-ichi
Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Japan.
Intern Med. 2011;50(19):2219-22. doi: 10.2169/internalmedicine.50.5552. Epub 2011 Oct 1.
We report a patient with rheumatoid arthritis (RA) who developed leukoencephalopathy while being treated with low-dose methotrexate (MTX). She suddenly developed loss of recent memory and left homonymous hemianopsia ascribable to the bilateral but right-predominant occipitotemporal lesions. Intravenous administration of dexamethasone and cessation of MTX quickly relieved her clinical symptoms. Low-dose MTX-induced leukoencephalopathy is a rare complication in RA, but is important with regard to the possibility of serious neurological sequellae.
我们报告了一名类风湿关节炎（RA）患者，该患者在接受小剂量甲氨蝶呤（MTX）治疗时发生了白质脑病。她突然出现近期记忆丧失和左侧同向性偏盲，这归因于双侧但以右侧为主的枕颞叶病变。静脉注射地塞米松和停用MTX迅速缓解了她的临床症状。小剂量MTX诱发的白质脑病在RA中是一种罕见的并发症，但鉴于其可能导致严重的神经后遗症，所以很重要。
