系统性红斑狼疮的自主神经紊乱:自身免疫性自主神经节病。

IF 2.7 Q3 IMMUNOLOGY
Immunological Medicine Pub Date : 2024-12-01 Epub Date: 2024-10-27 DOI:10.1080/25785826.2024.2422180
Naoto Azuma, Mai Nakano, Masao Tamura, Chie Ogita, Kazuhiro Kitajima, Tetsuya Furukawa, Kiyoshi Matsui
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引用次数: 0

摘要

系统性红斑狼疮(SLE)自律神经失调的病理机制仍不清楚。我们在此报告了一名可能由自身免疫性自主神经节病(AAG)引起自主神经紊乱的系统性红斑狼疮患者。一名 42 岁的系统性红斑狼疮女性患者因血小板减少和肾炎复发入院,当时她正在接受皮质类固醇和羟氯喹治疗。入院时,她出现体重减轻、头晕、腹胀和排尿困难。超声波检查和计算机断层扫描发现她有明显的肠扩张、肾肿胀、双侧肾积水和输尿管扩张。肠道、尿道和膀胱均未发现梗阻迹象。磁共振成像也排除了横贯性脊髓炎的可能。在开始对复发性系统性红斑狼疮进行治疗(静脉注射免疫球蛋白和甲基强的松龙脉冲疗法,然后口服大剂量皮质类固醇、霉酚酸酯和他克莫司)后,正压性头晕、腹胀和排尿困难症状有所缓解,血小板计数增加,尿蛋白减少。肠扩张、肾积水和输尿管扩张的症状也有所改善。根据抗神经节乙酰胆碱受体抗体阳性,我们推断她的系统性红斑狼疮并发了 AAG。该病例提示,AAG 应被视为系统性红斑狼疮自主神经紊乱的一种类型。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Autonomic disorder in systemic lupus erythematosus: autoimmune autonomic ganglionopathy.

The pathomechanisms of autonomic disorders in systemic lupus erythematosus (SLE) remain unclear. We herein report a patient with SLE who developed autonomic disorders presumably caused by autoimmune autonomic ganglionopathy (AAG). A 42-year-old woman with SLE under treatment with corticosteroids and hydroxychloroquine was admitted for recurrence of SLE with thrombocytopenia and nephritis. On admission, she presented with weight loss, orthostatic dizziness, abdominal distension, and difficulty urinating. Marked intestinal dilatation, kidney swelling, bilateral hydronephrosis, and ureteral dilatation were noted on ultrasonography and computed tomography. No evidence of obstruction was observed in the intestines, urinary tracts, or bladder. Transverse myelitis was also ruled out by magnetic resonance imaging. After starting the treatment for the recurrent SLE (intravenous immunoglobulin and methylprednisolone pulse therapy, followed by high-dose oral corticosteroid, mycophenolate mofetil, and tacrolimus), orthostatic dizziness, abdominal distension, and difficulty urinating subsided along with increases in platelet count and decreases in urinary protein. The intestinal dilatation, hydronephrosis, and ureteral dilatation improved. We inferred that her SLE was complicated by AAG based on a positive anti-ganglionic acetylcholine receptor antibody. This case suggested that AAG should be considered as a type of autonomic disorder in SLE.

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来源期刊
Immunological Medicine
Immunological Medicine Medicine-Immunology and Allergy
CiteScore
7.10
自引率
2.30%
发文量
19
审稿时长
19 weeks
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