多发性硬化和风湿性疾病：类风湿关节炎、抗磷脂综合征和系统性红斑狼疮

Neurology perspectives Pub Date : 2025-07-01 DOI:10.1016/j.neurop.2025.100197

M.A. Hernández , B. González , Y. Contreras , L.M. Armas

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引用次数: 0

摘要

多发性硬化症（MS）可能与一系列风湿性疾病有关。类风湿性关节炎是一种慢性炎症性疾病，通常影响中小型关节。多发性硬化症与抗磷脂综合征有关。考虑到神经系统症状或中枢神经系统合并症的存在，必须仔细确定这些患者的治疗方案。多发性硬化症和类风湿关节炎患者不应使用TNF抑制剂治疗，因为这些可能会加重神经系统症状。大多数生物药物可能有利于中枢神经系统的机会性感染；因此，出现神经系统症状的患者应进行全面检查，并根据结果调整生物治疗。结论总结了风湿病合并多发性硬化症的主要治疗建议。

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Multiple sclerosis and rheumatic diseases: Rheumatoid arthritis, antiphospholipid syndrome, and systemic lupus erythematosus

Introduction

Multiple sclerosis (MS) may be associated with a range of rheumatic diseases. Rheumatoid arthritis is a chronic inflammatory disease typically affecting small- and medium-size joints. MS has been associated with antiphospholipid syndrome.

Development

The treatment of these patients must be carefully established, considering the presence of neurological symptoms or central nervous system comorbidities. Patients with MS and rheumatoid arthritis should not be treated with TNF inhibitors, as these may exacerbate the neurological symptoms. Most biological drugs may favour opportunistic infections of the central nervous system; therefore, patients developing neurological symptoms should undergo comprehensive examination, and biological treatment should be adapted according to the results.