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[一例系统性红斑狼疮合并多发颅内动脉瘤]

[A case of systemic lupus erythematosus associated with multiple intracranial aneurysms].

作者信息

Nagayasu S, Hanakita J, Miyake H, Suzuki T, Nishi S

出版信息

No Shinkei Geka. 1986 Sep;14(10):1251-5.

PMID:3785567
Abstract

The author reports a case of systemic lupus erythematosus (SLE) with multiple intracranial aneurysms and subarachnoid hemorrhage. A 31-year-old woman was admitted to the department of internal medicine of Shizuoka General Hospital for the treatment of nephrotic syndrome due to systemic lupus erythematosus on 1984. She spend an uneventful life until April, 1985 when she suddenly complained of severe headache and nausea. The computed tomographic scan revealed subarachnoid hemorrhage and the cerebral angiography showed multiple intracranial aneurysms and stenotic lesion. A review of the literature was made to clarify the incidence, the pathological change, and the prognosis of systemic lupus erythematosus with subarachnoid hemorrhage. The incidence of subarachnoid hemorrhage in SLE was about two percent in the reported clinical cases. The mechanisms of the subarachnoid hemorrhage and the aneurysmal formation in SLE seemed to be due to angitic changes, which involved the vessels of the whole body systematically. The exact prognosis of SLE with subarachnoid hemorrhage is difficult to say, but it seems to be unfortunately poor due to multiplicity of the lesion and the difficulty of its treatment.

摘要

作者报告了一例患有多发性颅内动脉瘤和蛛网膜下腔出血的系统性红斑狼疮(SLE)病例。一名31岁女性于1984年因系统性红斑狼疮导致的肾病综合征入住静冈综合医院内科。在1985年4月之前她生活正常,直到那时她突然抱怨严重头痛和恶心。计算机断层扫描显示蛛网膜下腔出血,脑血管造影显示多发性颅内动脉瘤和狭窄病变。为了阐明系统性红斑狼疮合并蛛网膜下腔出血的发病率、病理变化和预后,作者进行了文献综述。在已报道的临床病例中,SLE患者蛛网膜下腔出血的发生率约为2%。SLE患者蛛网膜下腔出血和动脉瘤形成的机制似乎是由于血管炎改变,这种改变系统性地累及全身血管。SLE合并蛛网膜下腔出血的确切预后难以确定,但由于病变的多发性及其治疗难度,其预后似乎不幸很差。

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