TY -的T1 -严重的红斑狼疮大脑炎JF -神经学乔-神经病学SP - S9 LP - S10 - 10.首页1212/01. wnl.0000903100.95793.8a六世99 - 23补充2非盟-克里斯托弗Szewczyk盟Hemil冈萨雷斯Y1 - 2022/12/05 UR - //www.ez-admanager.com/content/99/23_Supplement_2/S9.abstract N2 -客观狼疮大脑炎系统性红斑狼疮是一种罕见但有可能致命的并发症。及时诊断和快速启动疗法可以证明救生。背景我们提出一个31岁的女人给一个星期的急诊科发烧,头痛和混乱。审查系统是以分散的肌肉和关节疼痛,虚弱和皮疹。系统性红斑狼疮诊断和干燥的都是6个月前住院和治疗包括强的松、甲氨蝶呤和羟氯喹。她self-discontinued治疗六周之前在她的家乡厄瓜多尔寻找天然疗法。要害入院时102.2 F, 111次/分钟,96/67毫米汞柱,16188金宝慱官网下载次/分钟,95%的二氧化硫经鼻插管在2 L / min。体检是结膜充血,眼前房积脓(OD)和口腔溃疡可见出血。骨盆检查显示阴道粘膜的浅溃疡。神经系统检查是重要的分散的弱点。 There were punched-out ulcers on the digits of both hands. Laboratory markers of lupus disease activity were markedly abnormal. An MRI of the brain showed numerous punctate foci of restricted diffusion in the supra and infratentorial brain parenchyma. Few of the lesions showed subtle rim-enhancement and microhemorrhagic foci. CSF analysis showed 220 WBC/mL (70% PMNs), glucose 13 mg/dL and protein 63.7 mg/dL. No CSF oligoclonal bands were detected. CSF/serum albumin index showed mild impairment of the blood brain barrier. Cultures of CSF, blood, urine and sputum showed no growth.Design/Methods NA.Results The patient improved significantly upon initiation of pulsed corticosteroids, plasma exchange, and cyclophosphamide. She was transitioned to steroid-sparing agents and is doing well.Conclusions Lupus cerebritis can be the dominant syndrome in a patient presenting with uncontrolled SLE. Imaging and CSF findings can be dramatic and evoke infectious syndromes. Once alternative diagnoses have been ruled out lupus cerebritis should be managed aggressively to ensure good outcomes. ER -
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