Ribeiro F M, Signorelli F
1 Rheumatology Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
2 Internal Medicine Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Lupus. 2017 Apr;26(5):490-496. doi: 10.1177/0961203317691375.
Opportunistic infections can cause manifestations that resemble neuropsychiatric systemic lupus erythematosus and they can also trigger lupus flares. Therefore, central nervous system infections as differential diagnosis in neuropsychiatric systemic lupus erythematosus may be difficult, leading to delayed diagnosis and specific treatment. Central nervous system infection in systemic lupus erythematosus is not common but, if left misdiagnosed and not treated promptly, can be fatal. Complementary diagnosis tests are generally non-specific and disappointing. Caution with immunosuppressive drug treatment should be emphasized while an opportunistic infection cannot be ruled out. In this review, we discuss the various types of central nervous system infections reported in systemic lupus erythematosus patients, highlighting the importance of their early recognition in order to improve morbidity and mortality. Prevention with vaccination is a recommended approach.
机会性感染可引起类似神经精神性系统性红斑狼疮的表现，还可引发狼疮发作。因此，将中枢神经系统感染作为神经精神性系统性红斑狼疮的鉴别诊断可能存在困难，从而导致诊断延迟和缺乏特异性治疗。系统性红斑狼疮患者的中枢神经系统感染并不常见，但如果误诊且未及时治疗，可能会致命。辅助诊断检查通常缺乏特异性且结果令人失望。在不能排除机会性感染的情况下，应强调谨慎使用免疫抑制药物治疗。在本综述中，我们讨论了系统性红斑狼疮患者中报告的各种类型的中枢神经系统感染，强调了早期识别它们对于改善发病率和死亡率的重要性。推荐采用疫苗接种进行预防。
