Ho Tsung-Han, Hsu Yu-Wei, Wang Chih-Wei, Lee Jiunn-Tay, Ting Chi-Hsin, Yang Fu-Chi
Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Department of Radiology, Tri-Service General Hospital, National Defense Medical Center.
Acta Neurol Taiwan. 2016 Jun 15;25(2):65-69.
Although Sjögren's syndrome has been known to complicate with white matter lesions, encephalopathy, or stroke, reports of cerebral venous sinus thrombosis due to Sjögren's syndrome with atypical antibodies are rare.
A 50-year-old woman was admitted to our neurological ward with nausea and vomiting following acute onset of severe headache in the left occipital region. Brain computed tomography revealed no abnormalities. The patient was fully conscious, with normal cognitive functioning, but exhibited unsteady tandem gait. Both magnetic resonance venography and computed tomography venography suggested left transverse sinus blockage. Intravenous enoxaparin, followed by oral warfarin, was initiated as treatment for cerebral venous sinus thrombosis. After investigation, Sjögren's syndrome was diagnosed and lupus anticoagulant antibody test was positive. The patient was treated with hydroxychloroquine, and appeared fully recovered at the 6-month follow-up, with no clinical or radiological signs of relapse.
This case reports the relationship between cerebral venous sinus thrombosis and Sjögren's syndrome. It is necessary to screen autoimmune disorders in patients with cerebral venous sinus thrombosis that present with no common risk factors of venous thrombosis in order to prevent inappropriate management, and potentially adverse outcomes.
尽管已知干燥综合征会并发白质病变、脑病或中风,但关于伴有非典型抗体的干燥综合征导致脑静脉窦血栓形成的报道却很少见。
一名50岁女性因左枕部严重头痛急性发作后出现恶心、呕吐入住我院神经科病房。脑部计算机断层扫描未发现异常。患者意识清醒,认知功能正常,但表现出串联步态不稳。磁共振静脉造影和计算机断层扫描静脉造影均提示左侧横窦阻塞。开始静脉注射依诺肝素,随后口服华法林,作为脑静脉窦血栓形成的治疗方法。经过检查,诊断为干燥综合征,狼疮抗凝抗体检测呈阳性。患者接受羟氯喹治疗,在6个月的随访中似乎完全康复,没有复发的临床或影像学迹象。
本病例报告了脑静脉窦血栓形成与干燥综合征之间的关系。对于没有常见静脉血栓形成危险因素的脑静脉窦血栓形成患者,有必要筛查自身免疫性疾病,以防止不适当的治疗和潜在的不良后果。