PT -期刊文章盟凯伦曼迪盟Patricia Coyle AU -罗伯塔塞德曼盟Fawaz Al-Mufti AU -本尼金TI -炎症的变体渐进多焦点的脑白质病;在早期系统性红斑狼疮患者Erythrematosus (P07.055) DP - 2012年4月26日TA -神经病学PG - P07.055 P07.055 VI - 首页78 IP - 1补充4099 - //www.ez-admanager.com/content/78/1_Supplement/P07.055.short 4100 - //www.ez-admanager.com/content/78/1_Supplement/P07.055.full所以Neurology2012 4月26日;78 AB -目的:系统性红斑狼疮Erythrematosus (SLE)本身的风险可能使发展渐进多焦点的脑白质病(PML)背景的病例报告55岁女子与四个月历史的系统性红斑狼疮发达的炎症变体PML的设置最小的免疫抑制。设计/方法:病例报告。结果:55年女性最近被诊断出患有系统性红斑狼疮和放置在低剂量氯奎宁和强的松。四个月后她于带状疱疹和随后的治疗。大脑核磁共振得到设置神经衰落并显示多个T2 nonenhancing hyperintensities深白质。疾病和感染血清学重要积极的莱姆IGM免疫印迹;其他都是负面的。CSF透露JC病毒PCR是正面的。她与静脉注射头孢曲松治疗莱姆,强的松滴定发起,氯奎宁是停止。 The patient was referred to a PML specialist for further evaluation who felt that the rapid evolution of the symptoms, short exposure to steroids, and lack of profound imunnosuppression made the diagnosis of PML less likely. Four weeks later, the patient continued to have clinical worsening and new MRI enhancement. A brain biopsy was performed which revealed a macrophagic leukoencephalitis and glial intranuclear inclusions characteristic of PML with prominent perivascular inflammation. In situ hybridization for JC virus confirmed the diagnosis.Conclusions: Classically PML is seen in immunosuppressed patients although it has also been identified in patients with rheumatologic diseases, in particular SLE. Patients may have atypical onset of neurological deficits, inflammatory features on neuroimaging and biopsy, despite the lack of a profound immunosuppression or a short duration since initial diagnosis. The assumption that all new deficits are SLE flares and continued treatment with immunosuppressants could be detrimental hence the recognition of PML in the setting of SLE is critical to outcome.Disclosure: Dr. Medin has nothing to disclose. Dr. Coyle has received personal compensation for activities with Acorda Therapeutics, Avanir Pharmaceuticals, Bayer Pharmaceuticals Corporation, Biogen Idec, Genzyme Corporation, Novartis, Questcor, Roche Diagnostics Corporation, Sanofi-Aventis Pharmaceuticals, Inc., and Teva Neuroscience. Dr. Coyle has received personal compensation in an editorial capacity for NEURA. Dr. Coyle has received research support from Serono, Inc., Novartis, and Sanofi-Aventis Pharmaceuticals, Inc. Dr. Seidman has nothing to disclose. Dr. Al-Mufti has nothing to disclose. Dr. Kim has nothing to disclose.Thursday, April 26 2012, 14:00 pm-18:30 pm