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[原发性干燥综合征患者的脑梗死:一例报告及文献复习]

[Cerebral infarction in a patient with primary Sjogren's syndrome: a case report and literature review].

作者信息

Yang D, Qiao L, Zhao L D

机构信息

Department of Cardiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

Department of Rheumatology & Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2016 Dec 18;48(6):1077-1080.

Abstract

Sjogren's syndrome (SS) is a chronic autoimmune disorder characterized by lymphocytes infiltration in the exocrine glands. Central nervous system complications of primary SS are not rare, but ischemic stroke has been rarely reported. Here we report a 43-year-old female with a two-year history of primary SS, presenting with sudden cerebral infarction. Her primary SS was diagnosed on the basis of clinical features, high levels of serum anti-SSA and anti-SSB antibodies, salivary gland secretion evaluation and positive sublingual gland biopsy results. Magnetic resonance imaging revealed infarct lesions in the parietal and occipital lobes, as well as in the left basal ganglia. Magnetic resonance angiography showed a remarkable stenosis in the left middle cerebral artery. Other differential diagnoses were ruled out. Corticosteroid and immunosuppressor, together with anti-platelet and statin were effective, and the patient recovered quickly without sequelae. Based on these findings, vasculitis due to primary SS should be considered among the causes of stroke. The literature was reviewed and the relationship between primary SS and cerebral infarction explored. The pathogenesis of ischemic stroke in primary SS is still unknown and warrants further studies.

摘要

干燥综合征(SS)是一种慢性自身免疫性疾病,其特征是外分泌腺淋巴细胞浸润。原发性干燥综合征的中枢神经系统并发症并不少见,但缺血性中风鲜有报道。在此,我们报告一名43岁女性,有两年原发性干燥综合征病史,突发脑梗死。她的原发性干燥综合征根据临床特征、血清抗SSA和抗SSB抗体水平升高、唾液腺分泌评估以及舌下腺活检结果阳性而确诊。磁共振成像显示顶叶和枕叶以及左侧基底节有梗死灶。磁共振血管造影显示左侧大脑中动脉明显狭窄。排除了其他鉴别诊断。皮质类固醇和免疫抑制剂,联合抗血小板药物和他汀类药物治疗有效,患者恢复迅速,无后遗症。基于这些发现,原发性干燥综合征所致血管炎应被视为中风的病因之一。我们复习了文献并探讨了原发性干燥综合征与脑梗死之间的关系。原发性干燥综合征缺血性中风的发病机制仍不清楚,值得进一步研究。

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