以脑损害为首发症状的系统性红斑狼疮14例临床分析

目的研究以脑损害为首发症状的系统性红斑狼疮(SLE)的临床特点方法对14例以脑损害为首发症状的SLE患者进行回顾分析,对其脑损害首发症状、临床表现、实验室检查及治疗等进行分析总结结果SLE早期发生脑损害多为青年女性(占85.7%),脑损害症状以精神行为异常(42.9%)、癫痫(35.7%)为多见,SLE临床症状以肾脏损害(57.1%)、关节疼痛(50.0%)、面部蝶形红斑(50.0%)多见;免疫学检查抗核抗体阳性14例(100.0%),抗双链DNA抗体阳性10例(71.4%),狼疮细胞阳性8例(57.1%);脑电图检查异常12例(85.7%) 应用激素、免疫抑制剂及对症治疗后均恢复良好,无病例死亡结论以脑损害为首发病状的SLE早期诊断困难,对青年女性不明原因的精神行为异常、癫痫、头痛、偏瘫等症状应进行定期随访,注意排除SLE的可能。

Clinical analysis for systemic lupus erythematosus with brain damage as first symptom

Objective To investigate the clinical characters of systemic lupus erythematosus (SLE) with brain damage as first symptom. Methods The first symptom, clinical manifestations and experimental examination and treatment in 14 patients with SLE whose first symptom was brain damage were retrospectively analyzed. Results It was more common in young female SLE patients who occurred hrain damage as first symptom, which accounted for 85.7% , mental and behavior disorders accounted for 42.9% and epilepsy accounted for 35.7% .The clinical manifestations of SLE were mainly kidney damage (57. 1 % ), arthralgia (50.0% ), butterfly erythema (50. 0% ). Among 14 patients, 14 cases were positive in antinuclear antibody (100% ), 10 cases were positive in anti-double strand DNA antibody (71.4%),8 eases were positive in lupus cells (57. 1%) and 12 cases were abnormal in EEG examination (85.7% ). All the patients recovered well after treatment with hormone and immunosuppressive agents. Conclusion It is difficult to make early diagnosis for the SLE with brain damage as first symptom. Follow-up is necessary for young women with such symptoms as mental and behavior disorders, epilepsy, headache and hemiparasis whose causes are unknown in order to exclude the possibihty of SLE.