Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Lupus. 2012 Apr;21(5):542-7. doi: 10.1177/0961203311435267. Epub 2012 Feb 2.
To evaluate the occurrence of idiopathic intracranial hypertension (IIH) in patients with systemic lupus erythematosus (SLE) and to describe the manifestations, treatments and outcomes in these patients.
We reviewed the medical records of 1084 patients with SLE followed up from January 1997 to June 2011 in our unit. We identified patients with IIH and analyzed the demographic, clinical and laboratory characteristics of these patients.
Among the 1084 SLE patients, 47 underwent cerebrospinal fluid studies because of their intractable headache and eight (17%) of these were diagnosed as IIH. All were females aged 14 to 32 years. Nobody belonged to the obesity group. Headache, nausea, vomiting and blurred vision were the most common presenting symptoms. All patients had active SLE at the time of admission (SLE disease activity index ≥6). Five patients had lupus nephritis. In eight patients, there were two with antiphospholipid antibodies, two with anti-ribosomal P antibodies and six with anti-Ro antibodies. All subjects recovered without any complication after high dose steroid therapy.
IIH accounts for a considerable part of the causes of intractable headache in SLE patients and steroids should be considered as a first-line treatment.
评估红斑狼疮（SLE）患者中特发性颅内高压（IIH）的发生情况，并描述这些患者的临床表现、治疗方法和转归。
我们回顾了 1997 年 1 月至 2011 年 6 月期间在我科就诊的 1084 例 SLE 患者的病历资料。我们确定了 IIH 患者，并对这些患者的人口统计学、临床和实验室特征进行了分析。
在 1084 例 SLE 患者中，47 例因难治性头痛接受了脑脊液检查，其中 8 例（17%）被诊断为 IIH。所有患者均为 14 至 32 岁的女性，无肥胖患者。头痛、恶心、呕吐和视力模糊是最常见的首发症状。所有患者入院时均有活动期 SLE（SLE 疾病活动指数≥6）。5 例患者合并狼疮肾炎。8 例患者中，有 2 例抗磷脂抗体阳性，2 例抗核糖体 P 抗体阳性，6 例抗 Ro 抗体阳性。所有患者均在接受大剂量类固醇治疗后痊愈，无任何并发症。
IIH 是 SLE 患者难治性头痛的一个重要原因，类固醇应作为一线治疗药物。
