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神经精神性系统性红斑狼疮伴脑血管炎和狼疮性肾炎经大剂量糖皮质激素和霉酚酸酯治疗后成功缓解。

Neuropsychiatric Systemic Lupus Erythematosus with Cerebral Vasculitis and Lupus Nephritis Successfully Treated with High-dose Glucocorticoids and Mycophenolate Mofetil.

机构信息

Center for Post-Graduation Training, University of Miyazaki Hospital, Japan.

Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan.

出版信息

Intern Med. 2022 Oct 15;61(20):3131-3135. doi: 10.2169/internalmedicine.9123-21. Epub 2022 Mar 12.

DOI:10.2169/internalmedicine.9123-21
PMID:35283391
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9646341/
Abstract

Neuropsychiatric systemic lupus erythematosus (NPSLE) with cerebral vasculitis is rare, and its prognosis is unfavorable. High-dose glucocorticoids and cyclophosphamide are widely used for the treatment of NPSLE, but cyclophosphamide has a risk of cervical intraepithelial neoplasia and ovarian insufficiency, which may discourage its use in young women. We experienced a case of NPSLE with cerebral vasculitis and lupus nephritis that responded successfully to glucocorticoids and mycophenolate mofetil (MMF). MMF might be a treatment option for NPSLE without concern for reproductive toxicity. However, there are only a few reports on the efficacy of MMF in NPSLE, and further investigations are needed.

摘要

神经精神性系统性红斑狼疮（NPSLE）合并脑血管炎较为罕见，其预后不佳。大剂量糖皮质激素和环磷酰胺广泛用于治疗 NPSLE，但环磷酰胺有发生宫颈上皮内瘤变和卵巢功能不全的风险，这可能会使其在年轻女性中应用受限。我们遇到一例 NPSLE 合并脑血管炎和狼疮肾炎，经糖皮质激素和霉酚酸酯（MMF）治疗后成功缓解。MMF 可能是一种无生殖毒性担忧的 NPSLE 治疗选择。然而，关于 MMF 在 NPSLE 中的疗效的报道很少，需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71b7/9646341/5a56939f6847/1349-7235-61-3131-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71b7/9646341/2ee0b96ba8da/1349-7235-61-3131-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71b7/9646341/5a56939f6847/1349-7235-61-3131-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71b7/9646341/2ee0b96ba8da/1349-7235-61-3131-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71b7/9646341/5a56939f6847/1349-7235-61-3131-g002.jpg

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Neuroradiology. 2021 Oct;63(10):1635-1644. doi: 10.1007/s00234-021-02686-y. Epub 2021 Mar 8.
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Neuropsychiatric involvement in systemic lupus erythematosus: A review.神经精神性狼疮：综述。
Autoimmun Rev. 2021 Apr;20(4):102780. doi: 10.1016/j.autrev.2021.102780. Epub 2021 Feb 18.
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High-resolution MRI vessel wall imaging: spatial and temporal patterns of reversible cerebral vasoconstriction syndrome and central nervous system vasculitis.高分辨率MRI血管壁成像：可逆性脑血管收缩综合征和中枢神经系统血管炎的空间和时间模式
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Ann Rheum Dis. 2010 Dec;69(12):2074-82. doi: 10.1136/ard.2010.130476. Epub 2010 Aug 19.
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