Mohammadian Reza, Tarighatnia Ali, Naghibi Mehran, Koleini Evin, Nader Nader D
Neuroscience Research Center (NSRC), Tabriz University of Medical sciences, Tabriz, Iran.
Department of Anesthesiology, VA Western NY Healthcare System, New York.
J Stroke Cerebrovasc Dis. 2018 May;27(5):e80-e85. doi: 10.1016/j.jstrokecerebrovasdis.2017.12.003. Epub 2018 Jan 3.
Cerebral ischemia because of vertebrobasilar insufficiency (VBI) rarely presents as an initial sign within the systemic lupus erythematosus (SLE) population, and there are very few case reports supporting this manifestation. This report details 3 different patients with SLE who experienced VBI as an initial manifestation. Patient 1 was a 24-year-old female who developed a bilateral pontine lesion as a consequence of basilar artery stenosis. Patient 2 was a 34-year-old male with an acute ischemic lesion on the right side of his cerebellum and pons because of significant stenosis in the distal segment of the right vertebral artery. Patient 3 was a 37-year-old female, previously diagnosed with multiple sclerosis, with multiple lesions in her cerebellum and pons bilaterally. Further investigations within this case revealed severe stenosis of the left vertebral artery. The diagnosis of SLE was based on clinical presentations such as myalgia, skin rashes, ulcers, and fatigue along with relevant laboratory findings including positive anti ds-DNA antibody and depressed levels of complement C3 and C4 proteins. In young patients with multifocal ischemic lesions or infarcts in the posterior cerebral circulation system, physicians should investigate for less common etiologies such as SLE.
因椎基底动脉供血不足（VBI）导致的脑缺血在系统性红斑狼疮（SLE）患者中很少作为首发症状出现，且仅有极少数病例报告支持这一表现。本报告详细介绍了3例以VBI为首发表现的不同SLE患者。患者1是一名24岁女性，因基底动脉狭窄出现双侧脑桥病变。患者2是一名34岁男性，由于右侧椎动脉远端严重狭窄，在其小脑右侧和脑桥出现急性缺血性病变。患者3是一名37岁女性，既往诊断为多发性硬化症，双侧小脑和脑桥有多处病变。该病例的进一步检查发现左侧椎动脉严重狭窄。SLE的诊断基于肌痛、皮疹、溃疡和疲劳等临床表现以及相关实验室检查结果，包括抗双链DNA抗体阳性和补体C3及C4蛋白水平降低。对于在后脑循环系统有多灶性缺血性病变或梗死的年轻患者，医生应排查如SLE等少见病因。
