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抗磷脂综合征误诊为神经精神性狼疮1例并文献复习

张强 余楠楠 张天元 王常明 邓伟哲

中风与神经疾病杂志2024,Vol.41Issue(9):839-842,4.
中风与神经疾病杂志2024,Vol.41Issue(9):839-842,4.DOI:10.19845/j.cnki.zfysjjbzz.2024.0160

抗磷脂综合征误诊为神经精神性狼疮1例并文献复习

Antiphospholipid syndrome misdiagnosed as neuropsychiatric systemic lupus erythematosus:A case report and literature review

张强 1余楠楠 2张天元 3王常明 1邓伟哲1

作者信息

  • 1. 中国人民解放军联勤保障部队第九六二医院中医风湿科,黑龙江 哈尔滨 150048
  • 2. 中国人民解放军空军军医大学第一附属医院中医科,陕西 西安 710032
  • 3. 哈尔滨医科大学附属第四医院神经内科,黑龙江 哈尔滨 150001
  • 折叠

摘要

Abstract

When antiphospholipid syndrome(APS)and neuropsychiatric systemic lupus erythematosus(NPSLE)involve the central nervous system,the two diseases tend to have similar clinical symptoms and auxiliary examination re-sults and different diagnosis and treatment strategies,which may lead to potential misdiagnosis and mistreatment.This ar-ticle analyzes the causes of misdiagnosis and performs a literature review.A retrospective analysis was performed for one patient with thrombocytopenia and stroke as initial symptoms.The patient was initially diagnosed with NPSLE and was treated with hydroxychloroquine,glucocorticoids,mycophenolate mofetil to induce remission,and aspirin was given to prevent platelet aggregation.Subsequently,the patient developed a positive spectrum of antiphospholipid antibodies and venous thrombosis;therefore,the patient was diagnosed with APS and was given maintenance treatment with hydroxychlo-roquine and low-dose glucocorticoids and sequential therapy with low-molecular-weight heparin as an anticoagulant and in-dobufen for antiplatelet aggregation therapy.The patient had stable conditions without recurrence during follow-up for 5 months.Recognizing the initial symptoms and thrombotic events is crucial for the early diagnosis of APS and NPSLE.Fur-ther studies are needed to explore the long-term efficacy of indobufen as an alternative to aspirin in APS.

关键词

抗磷脂综合征/神经精神性狼疮/血小板减少/阿司匹林/吲哚布芬

Key words

Antiphospholipid syndrome/Neuropsychiatric systemic lupus erythematosus/Thrombocytope-nia/Aspirin/Indobufen

分类

医药卫生

引用本文复制引用

张强,余楠楠,张天元,王常明,邓伟哲..抗磷脂综合征误诊为神经精神性狼疮1例并文献复习[J].中风与神经疾病杂志,2024,41(9):839-842,4.

基金项目

黑龙江省医学发展基金项目(2023QY003) (2023QY003)

陕西省中医药管理局资助类课题(2019-ZZ-JC013) (2019-ZZ-JC013)

中风与神经疾病杂志

OACSTPCD

1003-2754

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