Nishida Hiroshi, Wakida Kenji, Sakurai Takeo
Department of Neurology, Gifu Prefectural General Medical Center, Japan.
Intern Med. 2015;54(7):837-41. doi: 10.2169/internalmedicine.54.3079. Epub 2015 Apr 1.
A 51-year-old woman undergoing steroid treatment for systemic lupus erythematosus (SLE) was admitted to our hospital after developing a fever, consciousness disturbance and seizures, leading to a diagnosis of SLE-induced meningoencephalitis. Although steroid therapy improved her symptoms, she complained of post-lumbar puncture thunderclap headaches during follow-up, and cerebral venous thrombosis (CVT) was subsequently diagnosed on magnetic resonance venography and cerebral angiography. This is a rare case of neuropsychiatric SLE complicated by CVT during treatment for aseptic meningoencephalitis. The onset of aseptic meningoencephalitis and administration of the lumbar puncture and steroid therapy may have induced the development of the patient's CVT symptoms.
一名51岁正在接受系统性红斑狼疮(SLE)类固醇治疗的女性,在出现发热、意识障碍和癫痫发作后入住我院,诊断为SLE诱发的脑膜脑炎。尽管类固醇治疗改善了她的症状,但她在随访期间抱怨腰椎穿刺后出现霹雳样头痛,随后磁共振静脉造影和脑血管造影诊断为脑静脉血栓形成(CVT)。这是一例罕见的神经精神性SLE在无菌性脑膜脑炎治疗期间并发CVT的病例。无菌性脑膜脑炎的发作以及腰椎穿刺和类固醇治疗的应用可能诱发了该患者CVT症状的发生。