多发性硬化症与系统性红斑狼疮并存——一例报告
Coexistence of multiple sclerosis and systemic lupus erythematosus - a case report.
作者信息
Dubaj Maciej, Dembowska Aleksandra, Bigosiński Karol, Belniak Ewa, Rejdak Konrad
机构信息
Student Scientific Society, Chair and Department of Neurology, Medical University of Lublin, Poland.
Chair and Department of Neurology, Medical University of Lublin, Poland.
出版信息
Postep Psychiatr Neurol. 2024 Mar;33(1):39-42. doi: 10.5114/ppn.2023.134444. Epub 2024 Jan 17.
PURPOSE
Multiple sclerosis (MS) and systemic lupus erythematosus (SLE) are two autoimmune diseases that are relatively common, especially in women. However, it is extremely rare for them to coexist in a single patient (only 18 cases have been recorded worldwide). Both affect the nervous system and may manifest in identical ways. This creates significant difficulties, both in terms of diagnosis and choice of appropriate therapy.
CASE DESCRIPTION
A 54-year-old female patient with quadriparesis, superficial sensory disturbance and gait and balance disorders was diagnosed with primary progressive MS according to McDonald's criteria. The magnetic resonance images were typical for MS. Previously, in 2013, she was diagnosed with SLE, treated successfully, and is currently in remission. After excluding neuropsychiatric lupus, ocrelizumab treatment was administered, with good clinical results.
COMMENT
Adequate differentiation (magnetic resonance imaging, analysis of cerebrospinal fluid, clinical observation) as to whether the patient's symptoms are related to MS or to SLE nervous system involvement is the basis for proper diagnosis and treatment.
目的
多发性硬化症（MS）和系统性红斑狼疮（SLE）是两种相对常见的自身免疫性疾病，尤其是在女性中。然而，它们在同一患者中共存极为罕见（全球仅记录了18例）。两者都会影响神经系统，且可能以相同的方式表现出来。这在诊断和选择合适的治疗方法方面都造成了重大困难。
病例描述
一名54岁的女性患者，出现四肢无力、浅感觉障碍以及步态和平衡障碍，根据麦克唐纳标准被诊断为原发性进行性MS。磁共振成像表现符合MS的典型特征。该患者曾在2013年被诊断为SLE，经治疗后成功缓解，目前处于缓解期。在排除神经精神性狼疮后，给予奥瑞珠单抗治疗，临床效果良好。
评论
对患者症状是与MS相关还是与SLE神经系统受累相关进行充分鉴别（磁共振成像、脑脊液分析、临床观察）是正确诊断和治疗的基础。
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