Fujita Yuya, Fukui Shoichi, Ishida Midori, Endo Yushiro, Tsuji Sosuke, Takatani Ayuko, Igawa Takashi, Shimizu Toshimasa, Umeda Masataka, Sumiyoshi Remi, Nishino Ayako, Koga Tomohiro, Kawashiri Shin-Ya, Iwamoto Naoki, Ichinose Kunihiro, Tamai Mami, Nakamura Hideki, Origuchi Tomoki, Kawakami Atsushi
Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan.
Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan.
Intern Med. 2018 Oct 15;57(20):3025-3028. doi: 10.2169/internalmedicine.0934-18. Epub 2018 May 18.
A 70-year-old Japanese woman presented to our hospital with gait disturbance and cognitive dysfunction. Since she had arthritis, lymphopenia, hypocomplementemia, and anti-nuclear and anti-double-stranded DNA antibodies, she was diagnosed with systemic lupus erythematosus (SLE). T2-weighted magnetic resonance imaging revealed bilateral hyperintensities in the putamen. Based on her cognitive impairment, muscle rigidity, and high levels of interleukin-6 in the cerebrospinal fluid, we believed she had developed a complication of a neuropsychiatric disease and administered corticosteroids and intravenous cyclophosphamide therapy. Her cognitive function fully recovered, and her gait disturbance improved. Attending to cognitive impairment in elderly SLE patients is necessary.
一名70岁的日本女性因步态障碍和认知功能障碍前来我院就诊。由于她有关节炎、淋巴细胞减少、补体血症低下以及抗核抗体和抗双链DNA抗体，她被诊断为系统性红斑狼疮（SLE）。T2加权磁共振成像显示双侧壳核高信号。基于她的认知障碍、肌肉僵硬以及脑脊液中白细胞介素-6水平升高，我们认为她出现了神经精神疾病并发症，并给予了皮质类固醇和静脉注射环磷酰胺治疗。她的认知功能完全恢复，步态障碍也有所改善。关注老年SLE患者的认知障碍是必要的。
