Inagaki Takahiko, Kudo Kotaro, Kurimoto Naoki, Aoki Takashi, Kuriyama Kenichi
Biwako Hospital, 1-8-5, Sakamoto, Otsu, Shiga 520-0113, Japan.
Department of Psychiatry, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan.
Case Reports Immunol. 2020 Nov 3;2020:8881503. doi: 10.1155/2020/8881503. eCollection 2020.
Sjögren's syndrome (SS) is a chronic autoimmune disorder, often associated with some neuropsychiatric symptoms as well as systemic lupus erythematosus. Although catatonia is frequently reported in patients with systemic lupus erythematosus, it has been rarely reported in patients with SS. Herein, we present a case of SS with catatonia effectively and safely treated with modified electroconvulsive therapy (ECT). A 58-year-old woman showed prolonged catatonia and depressive mood along with pathologically dried eye and mouth. Based on physical findings and blood tests, she was diagnosed with SS. Because of the presence of pressure sores, we were unable to perform lumbar puncture for the diagnosis of abacterial encephalitis. Alternatively, single-photon emission computed tomography of her brain revealed multifocal hypoperfused areas in the parietotemporal region. Consequently, we performed ECT for the treatment of catatonia comorbid with SS. Following 20 sessions of ECT, the catatonia was improved without obvious adverse effects. One week after the last ECT, elevated levels of interleukin-6 were identified in the cerebral fluid. After receiving steroid pulse therapy, she has not experienced catatonia for more than 5 years. SS can cause catatonia, and ECT is a safe and effective option for the treatment of catatonia with SS.
干燥综合征（SS）是一种慢性自身免疫性疾病，常伴有一些神经精神症状以及系统性红斑狼疮。虽然紧张症在系统性红斑狼疮患者中经常有报道，但在干燥综合征患者中却鲜有报道。在此，我们报告一例采用改良电休克治疗（ECT）有效且安全地治疗的伴有紧张症的干燥综合征病例。一名58岁女性表现出持续性紧张症和抑郁情绪，同时伴有病理性的眼干和口干。根据体格检查结果和血液检查，她被诊断为干燥综合征。由于存在压疮，我们无法进行腰椎穿刺以诊断无菌性脑炎。另外，她的脑部单光子发射计算机断层扫描显示颞顶叶区域存在多灶性灌注不足区域。因此，我们对该伴有干燥综合征的紧张症患者进行了ECT治疗。经过20次ECT治疗后，紧张症得到改善且无明显不良反应。最后一次ECT治疗一周后，在脑脊液中发现白细胞介素-6水平升高。接受类固醇冲击治疗后，她已超过5年未再出现紧张症。干燥综合征可导致紧张症，ECT是治疗伴有干燥综合征的紧张症的一种安全有效的选择。
