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一名年轻患者的小脑共济失调:通往狼疮的罕见路径。

Cerebellar ataxia in a young patient: A rare path to lupus.

作者信息

Ghosh Kaushik, Chatterjee Atri, Ghosh Susmita, Chakraborty Sisir

机构信息

Department of Medicine, Malda Medical College, Kolkata, West Bengal, India.

Department of Neurology, Nilratan Sircar Medical College, Kolkata, West Bengal, India.

出版信息

J Neurosci Rural Pract. 2014 Nov;5(Suppl 1):S75-6. doi: 10.4103/0976-3147.145212.

DOI:10.4103/0976-3147.145212
PMID:25540550
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4271393/
Abstract

Cerebellar ataxia is a rare manifestation of neuropsychiatric systemic lupus erythematosus (SLE). Development of vasculitic infarcts in the cerebellum is the most plausible reason of this manifestation. We report the case of a patient who presented with characteristic skin rashes of lupus along with cerebellar signs. Imaging of brain in this patient revealed prominent cerebellar atrophy. She was treated with mycophenolate mofetil and oral corticosteroid, and there was no further progression of her neurological signs after the initiation of therapy. In the clinical context of varied presentations of neurolupus, this is one of the rare sightings and our treatment protocol holds promise as first-line therapy in future.

摘要

小脑共济失调是神经精神性系统性红斑狼疮(SLE)的一种罕见表现。小脑血管炎性梗死的发生是这种表现最合理的原因。我们报告一例患者,其出现狼疮特征性皮疹及小脑体征。该患者脑部影像学检查显示明显的小脑萎缩。她接受了霉酚酸酯和口服糖皮质激素治疗,治疗开始后其神经体征未进一步进展。在神经狼疮表现多样的临床背景下,这是罕见病例之一,我们的治疗方案有望成为未来的一线治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa35/4271393/5fe8ce52e08a/JNRP-5-75-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa35/4271393/5fe8ce52e08a/JNRP-5-75-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa35/4271393/5fe8ce52e08a/JNRP-5-75-g002.jpg

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本文引用的文献

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Cerebellar degeneration associated with Sjögren's syndrome.与干燥综合征相关的小脑退行性变。
J Clin Neurol. 2012 Jun;8(2):155-9. doi: 10.3988/jcn.2012.8.2.155. Epub 2012 Jun 29.
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Massive vasculitic cerebellar infarction in patient with systemic lupus erythematosus.系统性红斑狼疮患者的大面积血管炎性小脑梗死
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Subacute cerebellar ataxia and atrophy developed in a young woman with systemic lupus erythematosus whose cerebrospinal fluid was positive for antineuronal cell antibody.
一例罕见的由电压门控钙通道和谷氨酸脱羧酶自身抗体引起的小脑共济失调病例。
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Cerebellar ataxia and obstructive hydrocephalus, rare neurologic presentations in patients with systemic lupus erythematosus.小脑共济失调和阻塞性脑积水,系统性红斑狼疮患者罕见的神经系统表现。
Rheumatol Int. 2017 Nov;37(11):1917-1930. doi: 10.1007/s00296-017-3773-7. Epub 2017 Jul 13.
5
Commentary.评论
J Neurosci Rural Pract. 2014 Nov;5(Suppl 1):S77.
一位年轻的系统性红斑狼疮女性出现亚急性小脑性共济失调和萎缩,其脑脊液抗神经元细胞抗体阳性。
Lupus. 2012 Mar;21(3):324-8. doi: 10.1177/0961203311418270. Epub 2011 Sep 30.
4
Acute cerebellar ataxia in lupus.狼疮性急性小脑共济失调。
Lupus. 2011 Oct;20(12):1312-5. doi: 10.1177/0961203311403346. Epub 2011 Jun 13.
5
Subacute pancerebellar syndrome associated with systemic lupus erythematosus.与系统性红斑狼疮相关的亚急性小脑综合征
Clin Neurol Neurosurg. 1996 May;98(2):157-60. doi: 10.1016/0303-8467(96)00013-3.
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Purkinje cell antibody in lupus ataxia.狼疮性共济失调中的浦肯野细胞抗体。
Lancet. 1993 Aug 7;342(8867):375-6. doi: 10.1016/0140-6736(93)91524-p.