뇌 혈관계를 침범한 전신성 홍반성 루푸스 2례

Two Cases of Systemic Lupus Erythematosus with Cerebrovascular Involvement

저자들은 최근 루푸스가 뇌 혈관계를 침범하여 신경 정신과적 이상 증상을 보였으며 면역 검사, 뇌파 검사 및 뇌 자기공명사진에서 중추 신경 루푸스의 소견에 부합되는 양상을 보였고 고용량의 부신피질 호르몬 충격 요법에 반응이 좋았던 2례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Systemic lupus erythematosus(SLE) is an autoimmune disease which may affect many different organs and disclose various clinical manifestations. Recently central nervous system(CNS) involvement has been recognized as an increasingly significant contributor to morbidity and mortality of SLE. The clinical manifestations of CNS-lupus are highly variable and range from mild cognitive dysfunction, movement disorder, headache, psychosis to life-threatening stroke and coma. Among the neuropsychiatric disorders encountered in patients with SLE, cerebrovascular disease has been a relatively rare complication. The diagnosis and management of CNS-lupus is difficult because of the lack of useful diagnostic methods. If cerebrovascular involvement is suspected, aggressive treatment such as high dose steroid, immunosuppressive therapy, plasma exchange may be required to reduce high mortality rate. We experienced 2 cases cerebrovascular dis eases occurring in SLE patients which presented with various neuropsychiatric manifestations. They were diagnosed as CNS-lupus by neuropsychiatric symptoms, brain MRI, and BEG, and showed good response to high dose steroid pulse therapy.