RESUMO
At present, central nervous system involvement is the most common in neuropsychiatric lupus.This article discus-ses the research status of central nervous system lupus in the past few years which include characteristics of clinical presentation, etio-pathological mechanism, neuroimaging diagnosis and therapeutic strategy.Actually, the advanced technology, especially neuroimmu-nology and neuroimaging, in combination with early diagnosis, effective assessment and treat to target strategy could decrease global disease activity, ameliorate quality of life and increase life expectancy.Furthermore, the prospective researches should be paid more attention in lupus registries, neuropsychiatric questionnaires, damage index and improvement of severe refractory cases in clinic.
RESUMO
A 31-year-old woman was referred to our hospital and diagnosed as overlap syndrome with systemic lupus erythematosus and dermatomyositis. After completing the fourth cycle of intravenous immunoglobulin therapy, the patient developed acute confusional state with the Glasgow Coma Scale of 7. Considering the lack of response to high dose corticosteroid therapy (methylprednisolone 1 g per day for 3 days), rituximab (500 mg per week) was administered twice. The next day after the administration of the first dose of rituximab, the level of consciousness started to improve and 15 days after rituximab, mental status was fully recovered. The proportion of CD19+ B cells started to decrease within 1 week after the administration of rituximab and remained depleted for 14 weeks. There was also a gradual decrease in serum CD40 and CD80 concentration measured by ELISA up to 4 months. This case suggests the effect of rituximab for the treatment of neuropsychiatric lupus.
Assuntos
Feminino , HumanosRESUMO
Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of unknown cause, and is characterized by appearance of various autoantibodies and multiple organ involvement. Some of the systems commonly involved in SLE include the muscle and joints, brain and peripheral nervous system, lungs, heart, kidneys, skin, serous membranes, and component of blood. The clinical manifestations of SLE is protean, overlap with other illnesses, and are often subtle. However there are few documented reports on SLE associated with Crohn's disease in other countries and no reporting case in Korea. We experienced a 30-year-old female patient who was admitted for right leg swelling and diagnosed as SLE with Crohn's disease.