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儿童起病系统性红斑狼疮患者颅内静脉窦血栓形成的临床特征:来自中国的单中心研究。

Clinical characteristics of cerebral venous sinus thrombosis in childhood-onset systemic lupus erythematosus patients: a single-centre study from China.

机构信息

Department of Rheumatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

出版信息

Clin Exp Rheumatol. 2021 Nov-Dec;39(6):1440-1445. doi: 10.55563/clinexprheumatol/kn8hco. Epub 2021 May 5.

Abstract

OBJECTIVES

Cerebral venous sinus thrombosis (CVST) is a rare complication of childhood-onset SLE (cSLE) and is potentially fatal to the patient. In order to better define the characteristics of CVST in cSLE, we analysed a single-centre study of cSLE presenting with CVST.

METHODS

Clinical characteristics and laboratory findings of cSLE patients complicated with CVST from January 2006 to December 2019 were analysed through this retrospective, single-centre study.

RESULTS

A total of 1395 records of cSLE patients were reviewed. Five patients (0.36%) had CVST. Headache (80%) was the most frequent symptom. The transverse sinus (45%) was the most frequent location of thrombus, followed by the sigmoid sinus (27%). The SLE disease activity index (SLEDAI) at the time of CVST was 11±3. The D-dimer was elevated in all 5 cases, only one patient was positive for ACL and anti-β2GP-I IgM. All the patients underwent MRV screen to confirm the diagnosis. All the patients had a favourable outcome after receiving glucocorticoid and immunosuppressant treatment, as well as anticoagulant therapy.

CONCLUSIONS

CVST is relatively rare in cSLE and tends to occur in active lupus patients. Severe and persistent headache is an index of CVST. Early diagnosis and more intensive therapy for SLE, combined with anticoagulation therapy, could significantly improve the prognosis of CVST in cSLE.

摘要

目的

脑静脉窦血栓形成(CVST)是儿童期发病的系统性红斑狼疮(cSLE)的罕见并发症,对患者有潜在致命危险。为了更好地定义 cSLE 并发 CVST 的特征,我们分析了一项 cSLE 并发 CVST 的单中心研究。

方法

通过回顾性单中心研究,分析了 2006 年 1 月至 2019 年 12 月期间患有 CVST 的 cSLE 患者的临床特征和实验室检查结果。

结果

共回顾了 1395 例 cSLE 患者的记录,其中 5 例(0.36%)患有 CVST。头痛(80%)是最常见的症状。横窦(45%)是血栓最常见的部位,其次是乙状窦(27%)。CVST 时的系统性红斑狼疮疾病活动指数(SLEDAI)为 11±3。5 例患者的 D-二聚体均升高,仅 1 例 ACL 和抗β2GP-I IgM 阳性。所有患者均进行 MRV 筛查以确认诊断。所有患者在接受糖皮质激素和免疫抑制剂治疗以及抗凝治疗后均取得良好结局。

结论

CVST 在 cSLE 中相对少见,且往往发生在活动期狼疮患者中。严重且持续的头痛是 CVST 的一个指标。早期诊断和更强化的 SLE 治疗,结合抗凝治疗,可显著改善 cSLE 并发 CVST 的预后。

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