中华临床免疫和变态反应杂志2016，Vol.10Issue(3)：213-218,6.DOI:10.3969/j.issn.1673-8705.2016.03.006
系统性红斑狼疮并发血栓性血小板减少性紫癜患者神经系统表现
Clinical Feature of Neurological Manifestations of Thrombotic Thrombocytopenic Purpura Associated with Systemic Lupus Erythematosus
张莉 1曾小峰 2李梦涛 2蒋颖 2王迁 2王立 2吴婵媛 2刘金晶 2周佳鑫 2张奉春2
作者信息
- 1. 中国医学科学院北京协和医学院北京协和医院内科，北京100730
- 2. 中国医学科学院 北京协和医学院 北京协和医院风湿免疫科，北京100730
- 折叠
摘要
Abstract
Objective To analyze the clinical features of neurological manifestations of thrombotic thrombocytopenic purpura associated with systemic lupus Erythematosus.Methods The neurological characteristics and brain imaging of 17 patients with thrombotic thrombocytopenic purpura associated with systemic lupus Erythematosus accepted of Peking Union Medical College Hospital from 2011 to 2015 were retrospectively analyzed.Results Neurological symptoms occurred in 94% ( 16/17 ) of cases.The neurological symptoms included disturbance of consciousness (59%, 10/17), seizure (47%, 8/17), focal abnormalities (29%, 5/17 ) and headache ( 24%, 4/17 ) .75% ( 9/12 ) of cases presented positive results in brain CT or MR.Multiple areas were affected in the majority ( 89%, 8/9 ) .22%(2/9) of cases had evidence of posterior reversible encephalopathy syndrome, and 44% (4/9) had ischemic lesions.Eight patients were given steroids pulse therapy and four of them recovered.Nine patients were treated with methylprednisolone pulse therapy combined with plasmapheresis and seven of them recovered.During the follow-up, 1 died, 4 gave up with exacerbated symptoms, 1 remained dialysis and 11 recovered.Of 11 patients who recovered, 2 had neurological deficit left.Conclusions The main neurological manifestations of TTP associated with SLE are disturbance of consciousness and seizure, and focal abnormalities can occur.The majority of cases have positive findings in brain CT or MR with multiple areas affected.65% of cases recovered after therapy and the minority of them have neurological deficit left.关键词
红斑狼疮, 系统性/紫癜, 血栓性血小板减少性Key words
lupus erythematosus, systemic/purpura, thrombosic thrombocytopenic分类
医药卫生引用本文复制引用
张莉,曾小峰,李梦涛,蒋颖,王迁,王立,吴婵媛,刘金晶,周佳鑫,张奉春..系统性红斑狼疮并发血栓性血小板减少性紫癜患者神经系统表现[J].中华临床免疫和变态反应杂志,2016,10(3):213-218,6.
