Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA.
J Clin Neurosci. 2013 Aug;20(8):1168-70. doi: 10.1016/j.jocn.2012.09.022. Epub 2013 May 8.
Systemic sclerosis (SSc) or scleroderma is a connective tissue disease with a diverse array of clinical manifestations secondary to underlying fibrosis and autoimmunity. Central nervous system (CNS) impairment is uncommon in SSc. Here we report the fourth known patient with CNS vasculitis caused by SSc. In each previous report, the patient was a middle-aged to elderly female. Our patient was 24 years old at the time of presentation, significantly younger than the other reported patients. Importantly, our patient's rapidly progressive clinical course and poor response to immunosuppression have not been reported in patients with CNS vasculitis secondary to scleroderma. Although CNS vasculitis is extremely rare in SSc, our report suggests that clinicians should consider this diagnosis in the differential of SSc patients with neurologic impairment.
系统性硬化症(SSc)或硬皮病是一种结缔组织疾病,由于潜在的纤维化和自身免疫,其临床表现多种多样。中枢神经系统(CNS)损害在 SSc 中并不常见。在这里,我们报告了第四例由 SSc 引起的中枢神经系统血管炎患者。在之前的每一份报告中,患者都是中年至老年女性。我们的患者在发病时年仅 24 岁,明显比其他报告的患者年轻。重要的是,我们患者的快速进展的临床病程和对免疫抑制的不良反应在继发于硬皮病的中枢神经系统血管炎患者中尚未被报道过。尽管中枢神经系统血管炎在 SSc 中极为罕见,但我们的报告提示临床医生在 SSc 患者出现神经功能障碍时应考虑这一诊断。