Diffuse leukoencephalopathy and subacute parkinsonism as an early manifestation of systemic lupus erythematosus.
Diffuse leukoencephalopathy and subacute parkinsonism as an early manifestation of systemic lupus erythematosus.
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弥漫性白质脑病和亚急性帕金森病是系统性红斑狼疮的早期表现。
DOI：
10.1155/2013/367185
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发表时间：
2013
影响因子：
0.9
通讯作者：
Nakamoto,BeauK
中科院分区：
文献类型：
--
作者：
Tse,GaryG;Santos-Ocampo,AlbertoS;Chow,DominicC;McMurtray,AaronM;Nakamoto,BeauK
系统性红斑狼疮中的帕金森综合征是罕见的。弥漫性脑白质病同样罕见，预后差。我们介绍了一例50岁的菲律宾男性，在开始赖诺普利治疗后出现全身性盘状皮疹。尽管赖诺普利停药，皮疹仍持续存在，在接下来的三个月里，他迅速发展为进行性帕金森综合征。脑部MRI显示对称融合T2高信号，累及白色物质和基底节。符合美国流变学学会SLE分类的11项标准中的4项。一名风湿病学家诊断为SLE伴皮肤和中枢神经系统受累。显著的神经和放射学改善发生后，治疗与IV类固醇，随后延长锥度。本报告强调了一个亚急性帕金森综合征与弥漫性白质脑病作为系统性红斑狼疮的早期表现，导致了良好的恢复后，只用免疫抑制剂治疗。
Parkinsonism in SLE is rare. Diffuse leukoencephalopathy is equally uncommon and is associated with a poor prognosis. We present a single case of a 50‐year‐old Filipino man who presented with a generalized discoid rash after starting lisinopril. The rash persisted despite discontinuation of lisinopril, and over the next three months, he developed rapidly progressive parkinsonism. Brain MRI showed symmetric confluent T2‐hyperintensities involving the white matter and basal ganglia. Four of the 11 American College of Rheumatology criteria for the classification of SLE were met. A rheumatologist made a diagnosis of SLE with cutaneous and central nervous system involvement. Significant neurologic and radiologic improvement occurred following treatment with IV steroids followed by a prolonged taper. This report highlights a case of subacute parkinsonism with a diffuse leukoencephalopathy as an early manifestation of SLE which resulted in a good recovery following treatment with only immunosuppressive therapy.