Prins J M, de Glas-Vos J W
Academisch Medisch Centrum, afd. Interne Geneeskunde, Amsterdam.
Ned Tijdschr Geneeskd. 1990 Nov 17;134(46):2252-6.
A 30-year-old woman, who in the past was diagnosed as having systemic lupus erythematosus (SLE) and had been treated accordingly, consulted us with neuropsychiatric symptoms, including mutism and catatonia. ANA and anti-dsDNA in serum were negative, and she did not fulfill the ARA criteria for a diagnosis of SLE. However, in view of her history and the fact that she developed convulsions and a transient, unexplained period of leukopenia during admission, her current illness could be interpreted as a cerebral manifestation of SLE. After increasing the dosage of prednisone, she recovered almost completely from this episode. The literature concerning possible procedures to diagnose neuropsychiatric manifestations of SLE is reviewed; it turns out that especially the primary form of cerebral SLE often causes diagnostic problems.
一名30岁女性，既往被诊断为系统性红斑狼疮（SLE）并接受了相应治疗，现因包括缄默症和紧张症在内的神经精神症状前来就诊。血清抗核抗体（ANA）和抗双链DNA（anti-dsDNA）均为阴性，且她不符合美国风湿病学会（ARA）的SLE诊断标准。然而，鉴于她的病史以及入院期间出现惊厥和短暂不明原因白细胞减少的情况，她目前的病情可被解释为SLE的脑部表现。增加泼尼松剂量后，她几乎完全从此次发作中康复。本文回顾了有关诊断SLE神经精神表现的可能方法的文献；结果发现，尤其是脑部SLE的主要形式常常导致诊断困难。
