Shintani S, Ono K, Hinoshita H, Shiigai T, Tsuruoka S
Department of Neurology, Toride Kyodo General Hospital, Ibaraki, Japan.
Eur Neurol. 1993;33(1):13-6. doi: 10.1159/000116891.
A 47-year-old woman affected by systemic lupus erythematosus (SLE) presented with headache, fever, splenomegaly and edema of the lower extremities. CT showed diffuse low density in the cerebral white matter and marked splenomegaly in the abdomen. T2-weighted MR images showed diffuse high intensity lesions in the white matter. After immunosuppressive therapy with prednisolone, there was marked improvement in the cranial CT and MR appearances. The underlying pathological process was probably edema secondary to a lupus microangiopathy. SLE can be complicated by a widespread abnormality of the white matter with marked radiological changes but few neurological signs. In the present case, only an episodic mild hemiparesis for 3 weeks without seizure and psychiatric disturbance was found neurologically during the whole clinical course.
一名47岁患有系统性红斑狼疮（SLE）的女性出现头痛、发热、脾肿大和下肢水肿。CT显示脑白质弥漫性低密度，腹部脾脏明显肿大。T2加权磁共振成像显示白质弥漫性高信号病变。使用泼尼松龙进行免疫抑制治疗后，头颅CT和磁共振成像表现有明显改善。潜在的病理过程可能是狼疮性微血管病继发的水肿。SLE可伴有白质广泛异常及明显的影像学改变，但神经系统体征较少。在本病例中，整个临床过程中神经系统检查仅发现3周的发作性轻度偏瘫，无癫痫发作和精神障碍。
