Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan.
Department of Gastroenterology and Hepatology, Ayabe City Hospital, Japan.
Intern Med. 2021 Jan 1;60(1):59-66. doi: 10.2169/internalmedicine.4951-20. Epub 2020 Aug 22.
A 40-year-old man was admitted to the hospital due to both a worsening of symptoms associated with ulcerative colitis (UC), which had been diagnosed 3 years previously, and limb paralysis. Colonoscopy revealed severe pancolitis-type UC. He was diagnosed with cerebral vasculitis with multiple white matter infarctions associated with the disease activity of UC by contrast-enhanced head magnetic resonance imaging. Mesalazine at 4,000 mg/day and prednisolone at 60 mg/day were started, and the prednisolone dosage was thereafter gradually reduced and switched to golimumab. He achieved a long-term remission from UC, and thereafter his neurological abnormalities improved significantly. He had no recurrence of cerebral infarction.
一位 40 岁男性因溃疡性结肠炎(UC)相关症状恶化和肢体瘫痪而入院,该患者 3 年前被诊断为 UC。结肠镜检查显示严重的全结肠炎型 UC。对比增强头部磁共振成像显示,患者患有脑血管炎,伴有多发性脑白质梗死,与 UC 的疾病活动有关。给予患者美沙拉嗪 4000mg/天和泼尼松龙 60mg/天治疗,此后逐渐减少泼尼松龙剂量并换用戈利木单抗。患者 UC 达到长期缓解,此后神经功能异常显著改善。他没有再次发生脑梗死。