背景:系统性红斑狼疮(SLE)通常伴有神经精神(NP)表现。然而,典型的紧张症症状并不常见。神经精神SLE或其“模拟者”可能会导致NP症状,使鉴别诊断成为临床实践中的重大挑战。
方法:一名68岁女性SLE患者因水肿住院,肺部感染,经过多个疗程的皮质醇和免疫抑制治疗后,复发性真菌性口腔溃疡。入院五天后,昏迷,不动,mutism,观察到刚性。
方法:\"Mimickers\":由于一般医疗条件引起的紧张性障碍。
方法:最初,相关的实验室测试,影像学检查,并进行疾病活动指数评分。在患者亲属中进行了疾病原因的调查。随后,我们停用了莫西沙星,皮质类固醇,氟康唑,和其他药物,并插入胃管进行营养支持。在这个过程中,中药和针灸已被利用。
结果:3天后,患者康复,仅抱怨疲劳。
结论:当SLE出现NP症状时,必须做出正确的诊断,以便通过积极寻找诱导剂和临床来指导适当的治疗,实验室,和神经放射学特征可以帮助鉴别诊断。当治疗选择有限时,尝试各种组合策略是有益的,如中医和针灸。
BACKGROUND: Systemic lupus erythematosus (SLE) is frequently accompanied by neuropsychiatric (NP) manifestations. However, typical symptoms of catatonia are uncommon. Neuropsychiatric SLE or its \"mimickers\" may cause NP symptoms, making differential diagnosis a significant challenge in clinical practice.
METHODS: A 68-year-old female with SLE was hospitalized for edema, lung infection, and recurrent fungal mouth ulcers after multiple courses of cortisol and immunosuppressive therapy. Five days after admission, stupor, immobility, mutism, and rigidity were observed.
METHODS: \"Mimickers\": catatonic disorder due to a general medical condition.
METHODS: Initially, relevant laboratory tests, imaging studies, and the disease activity index score were performed. A survey of the causes of the disease was conducted among the patient\'s relatives. Subsequently, we discontinued moxifloxacin, corticosteroids, fluconazole, and other medications and inserted a gastric tube for nutritional support. During this process, traditional Chinese medicine and acupuncture have been utilized.
RESULTS: After 3 days, the patient recovered and only complained of fatigue.
CONCLUSIONS: When SLE presents with NP symptoms, it is essential to make a correct diagnosis in order to guide appropriate treatment by actively searching for inducers and clinical, laboratory, and neuroradiological characteristics that can aid in the differential diagnosis. When treatment options are limited, it can be beneficial to try a variety of combination strategies, such as traditional Chinese medicine and acupuncture.