Ikeda Natsuko, Yamada Shinichi, Yamamoto Masahiro, Tanaka Katsunori, Fujii Takao, Tsuji Tomikimi, Kimoto Sohei, Takahashi Shun
Department of Neuropsychiatry Wakayama Medical University Wakayama Japan.
Department of Psychiatry Wakayama Prefectural Mental Health Care Center Aridagawa Japan.
PCN Rep. 2022 Oct 6;1(4):e49. doi: 10.1002/pcn5.49. eCollection 2022 Dec.
Steroid dementia has been reported since the 1970s. In the current super-aged society, it increasingly receives attention because of the growing number of elderly people that are medicated with steroids for systemic rheumatic disease.
We report two cases of steroid dementia that were diagnosed as a result of careful observation of clinical symptoms and biological examination, including nuclear medicine tests. Cognitive and daily living functions were partially recovered in both cases after decrease or discontinuance of steroid medication in 2-year follow-up, but their daily living function could not be totally restored to premorbid level.
Cognitive dysfunction caused by steroids is suggested by these cases, although definitive diagnosis in these cases is not possible. It was partially reversible over the course of a few years, but some functional loss remains. Cognitive function should be assessed appropriately before, during, and after steroid treatment. Detailed differential diagnosis of neurodegenerative disorders and longitudinal follow-up is required when cognitive dysfunction is observed after initiation of steroid therapy.
自20世纪70年代以来，已有关于类固醇性痴呆的报道。在当前的超老龄化社会中，由于越来越多的老年人因全身性风湿性疾病而使用类固醇药物，它越来越受到关注。
我们报告两例类固醇性痴呆病例，这两例是通过对临床症状的仔细观察以及包括核医学检查在内的生物学检查而确诊的。在2年的随访中，两例患者在减少或停用类固醇药物后，认知和日常生活功能均有部分恢复，但他们的日常生活功能无法完全恢复到病前水平。
尽管这些病例无法进行明确诊断，但这些病例提示了类固醇引起的认知功能障碍。在几年的过程中它部分可逆，但仍有一些功能丧失。在类固醇治疗前、治疗期间和治疗后，应适当评估认知功能。在开始类固醇治疗后观察到认知功能障碍时，需要对神经退行性疾病进行详细的鉴别诊断并进行长期随访。
