SUNY Upstate Medical University, Syracuse, NY, USA.
J Investig Med High Impact Case Rep. 2021 Jan-Dec;9:23247096211008708. doi: 10.1177/23247096211008708.
Systemic lupus erythematosus is an autoimmune disease that affects multiple organs and organ systems, subsequently requiring an elaborate regimen for management. We present the case of a 63-year-old female who developed unrelenting symptoms of drug-induced lupus, which persisted even after the offending agent was withdrawn, unmasking her underlying systemic lupus erythematosus. She continued to develop neuropsychiatric symptoms, including mania and hallucinations, which complicated the management of her disease. After exhausting the bank of anti-inflammatory and immunomodulators recommended by current guidelines, we found that a combination of rituximab infusions with thiothixene, an antipsychotic agent, significantly improved our patient's neuropsychiatric symptoms. Further research should be conducted to determine the efficacy of rituximab in the treatment of resistant lupus cerebritis, and to validate the use of thiothixene in the management of neuropsychiatric symptoms secondary to lupus.
系统性红斑狼疮是一种自身免疫性疾病，可影响多个器官和系统，因此需要精心制定治疗方案。我们报告了一例 63 岁女性患者，她出现了药物诱导性狼疮的持续症状，即使停用了致病药物后仍持续存在，从而揭示了她潜在的系统性红斑狼疮。她继续出现神经精神症状，包括躁狂和幻觉，这使她的疾病管理变得复杂。在使用现行指南推荐的所有抗炎和免疫调节剂后，我们发现利妥昔单抗输注联合抗精神病药硫必利显著改善了患者的神经精神症状。应进一步研究以确定利妥昔单抗治疗耐药性狼疮性脑脊髓炎的疗效，并验证硫必利在治疗狼疮继发神经精神症状中的应用。
