Ikushima Hiroaki, Mitsutake Akihiko, Hideyama Takuto, Sato Tatsuya, Katsumata Junko, Seki Tomonari, Maekawa Risa, Kishida Yukiko, Shiio Yasushi
Department of Neurology Tokyo Teishin Hospital Tokyo Japan.
Department of Pathology Tokyo Teishin Hospital Tokyo Japan.
J Gen Fam Med. 2018 Feb 13;19(2):53-56. doi: 10.1002/jgf2.157. eCollection 2018 Mar.
Systemic lupus erythematosus (SLE) is a multisystem disorder, which occurs mostly in young women. However, late-onset SLE does exist and sometimes presents with an atypical, diversified course. We describe an 85-year-old woman who was admitted to our hospital for lower extremity edema and hand grip weakness. Chest computed tomography scan 4 days after admission demonstrated rapid accumulation of pleural and pericardial effusions, which did not exist on admission. She was diagnosed with pleuritis and pericarditis associated with very-late-onset SLE. Methylprednisolone pulse therapy resulted in a drastic improvement in serositis. Our case exemplifies the fact that patients with late-onset SLE sometimes follow an atypical course, which makes the clinical diagnosis difficult.
系统性红斑狼疮（SLE）是一种多系统疾病，多见于年轻女性。然而，迟发性SLE确实存在，且有时呈现非典型、多样化的病程。我们描述了一位85岁的女性，因下肢水肿和握力减弱入院。入院4天后的胸部计算机断层扫描显示胸腔和心包积液迅速积聚，入院时并不存在。她被诊断为与极迟发性SLE相关的胸膜炎和心包炎。甲基强的松龙冲击疗法使浆膜炎得到显著改善。我们的病例例证了迟发性SLE患者有时会遵循非典型病程这一事实，这使得临床诊断变得困难。
