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皮质类固醇疗法治疗色素失禁症急性神经症状的有效性

Effectiveness of Corticosteroid Therapy for Acute Neurological Symptoms in Incontinentia Pigmenti.

作者信息

Tomotaki Seiichi, Shibasaki Jun, Yunoki Yuki, Kishigami Makoto, Imagawa Tomoyuki, Aida Noriko, Toyoshima Katsuaki, Itani Yasufumi

机构信息

Department of Neonatology, Kanagawa Children's Medical Center, Yokohama city, Kanagawa Prefecture, Japan.

Department of Neonatology, Kanagawa Children's Medical Center, Yokohama city, Kanagawa Prefecture, Japan.

出版信息

Pediatr Neurol. 2016 Mar;56:55-58. doi: 10.1016/j.pediatrneurol.2015.12.002. Epub 2015 Dec 18.

Abstract

BACKGROUND

Incontinentia pigmenti is a rare neurocutaneous disorder that may result in neurological symptoms in addition to its characteristic skin rashes. The pathogenesis of central nervous system disorders in incontinentia pigmenti remains unclear, but it has been suggested that vascular abnormalities and inflammatory processes may play important roles. Notably, there is no established treatment for central nervous system disorders in incontinentia pigmenti. We report a neonate with acute neurological symptoms of incontinentia pigmenti who was effectively treated with corticosteroid therapy. We review the literature and discuss the pathophysiology, diagnosis, and treatment of acute central nervous system disorders in incontinentia pigmenti.

PATIENT DESCRIPTION

A 15-day-old girl with incontinentia pigmenti experienced neurological symptoms such as decreased level of consciousness and a weak sucking reflex. Magnetic resonance imaging revealed multiple cerebral infarctions. We administered corticosteroid therapy, and the symptoms improved immediately and significantly.

CONCLUSION

We suggest that corticosteroid therapy may be an effective treatment during the acute phase of central nervous system dysfunction due to incontinentia pigmenti. It is important to determine the existence of acute phase lesions on magnetic resonance imaging when neurological symptoms occur or worsen.

摘要

背景

色素失禁症是一种罕见的神经皮肤疾病,除了其特征性皮疹外,还可能导致神经症状。色素失禁症中枢神经系统疾病的发病机制尚不清楚,但有人认为血管异常和炎症过程可能起重要作用。值得注意的是,色素失禁症中枢神经系统疾病尚无既定的治疗方法。我们报告了一名患有色素失禁症急性神经症状的新生儿,其接受皮质类固醇治疗后有效。我们回顾了文献并讨论了色素失禁症急性中枢神经系统疾病的病理生理学、诊断和治疗。

患者描述

一名15天大患有色素失禁症的女孩出现了意识水平下降和吸吮反射减弱等神经症状。磁共振成像显示多处脑梗死。我们给予皮质类固醇治疗,症状立即明显改善。

结论

我们认为皮质类固醇治疗可能是色素失禁症所致中枢神经系统功能障碍急性期的有效治疗方法。当出现神经症状或症状恶化时,通过磁共振成像确定急性期病变的存在很重要。

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