Neuropsychiatric lupus: a mosaic of clinical presentations.

Neuropsychiatric lupus: a mosaic of clinical presentations.
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DOI:
10.1186/s12916-015-0269-8
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发表时间:
2015-03-04
期刊:
影响因子:
9.3
通讯作者:
Shoenfeld Y
Shoenfeld Y
中科院分区:
医学1区
文献类型:
--
作者:
Kivity S;Agmon-Levin N;Zandman-Goddard G;Chapman J;Shoenfeld Y

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近一半的系统性红斑狼疮患者有神经精神症状;然而,它对疾病严重程度、生活质量和预后的影响是巨大的。神经精神系统性红斑狼疮的症状可能从轻度弥漫性症状到急性危及生命的事件。尽管潜在的机制仍然在很大程度上尚未阐明,但已经确定了几种致病途径,例如抗体介导的神经毒性、抗磷脂抗体和其他机制引起的血管病变以及细胞因子诱导的神经毒性。在当前的综述中,我们描述了神经精神系统性红斑狼疮的流行病学、病理生理学、诊断和治疗方面的新​​旧内容。神经精神症状和特定机制之间可能存在的联系可能有助于我们将来对这种疾病的理解,从而制定更好的治疗策略。
Neuropsychiatric symptoms affect nearly half of the patients with systemic lupus erythematosus; however, the effect on disease severity, quality of life, and prognosis is tremendous. Symptoms of neuropsychiatric systemic lupus erythematosus may range from mild diffuse ones, to acute life threatening events. Although the underlying mechanisms are still largely unraveled, several pathogenic pathways are identified, such as antibody-mediated neurotoxicity, vasculopathy due to anti-phospholipid antibodies and other mechanisms, and cytokine-induced neurotoxicity. In the current review, we describe the old and the new regarding epidemiology, pathophysiology, diagnosis, and management of neuropsychiatric systemic lupus erythematosus. The possible link between neuropsychiatric symptoms and specific mechanisms may help to facilitate our understanding of the disease in the future, thus allowing for better treatment strategies.
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