假性脑瘤作为青少年系统性红斑狼疮的首发表现
Pseudotumor Cerebri as the First Manifestation of Juvenile Systemic Lupus Erythematosus.
作者信息
Raeeskarami Seyed-Reza, Shahbaznejad Leila, Assari Raheleh, Aghighi Yahya
机构信息
Department of Pediatrics, Pediatric Rheumatology Research Group, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
Department of Pediatrics, Tehran University of Medical Sciences, Tehran, IR Iran.
出版信息
Iran J Pediatr. 2016 Jul 12;26(5):e5176. doi: 10.5812/ijp.5176. eCollection 2016 Oct.
INTRODUCTION
Headache is a common neuropsychiatric manifestation of juvenile systemic lupus erythematous (JSLE). Pseudotumor cerebri (PTC) is an uncommon cause of headache, presenting especially in active JSLE. In this paper, we report a case of missed intractable headache that was eventually diagnosed as PTC and presented as the first manifestation of JSLE.
CASE PRESENTATION
A 9-year-old girl with a history of progressive headache for four months, fever, fatigue, myalgia, arthralgia, small-joint arthritis of the hands, and recent diplopia was referred to our clinic. The diagnosis of PTC in the background of JSLE was made based on her history, physical examination, positive laboratory findings, and increased intracranial pressure, with normal neuroimaging. Treatment with high-dose prednisolone led to dramatic resolution of the headache.
CONCLUSIONS
It seems that a complete neurologic examination in newly diagnosed SLE patients is mandatory, especially in the presence of any neuropsychiatric manifestations, such as headache.
引言
头痛是青少年系统性红斑狼疮（JSLE）常见的神经精神症状。假性脑瘤（PTC）是一种不常见的头痛病因，尤其在活动期JSLE中出现。在本文中，我们报告了一例被漏诊的顽固性头痛病例，最终被诊断为PTC，并作为JSLE的首发表现。
病例介绍
一名9岁女孩，有四个月进行性头痛病史，伴有发热、疲劳、肌痛、关节痛、手部小关节关节炎，近期出现复视，转诊至我院门诊。根据其病史、体格检查、实验室检查阳性结果及颅内压升高且神经影像学检查正常，诊断为JSLE背景下的PTC。大剂量泼尼松龙治疗使头痛显著缓解。
结论
新诊断的SLE患者似乎必须进行全面的神经系统检查，尤其是在出现任何神经精神症状，如头痛时。
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