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1
題名:Myelitis in patients with systemic lupus erythematosus     (16點)
全身性紅斑性狼瘡病人之脊髓炎
著者:Chung-Yuan Hsu(許鐘元) ;Wen-Chan Chiu(邱文燦) ;Tsong-Shing Yang(楊聰信) ;Ching-Lan Chou(周靜蘭) ;Yu-Jih Su(蘇昱日) ;Shan-Fu Yu(尤珊富) ;Chun-Kai Chiu(邱俊凱) ;Ying-Chou Chen(陳英州) ;Han-Ming Lai(賴漢明) ;Tien-Tsai Cheng(鄭添財) ;Chung-Jen Chen(陳忠仁)
出版地區:台灣
出版城市:台中市
學科:醫學綜合
關鍵字:紅斑性狼瘡 ; 脊髓炎 ; 脊髓病變 ; Systemic lupus erythematosus ; myelitis ; myelopathy
刊名:Formosan Journal of Rheumatology
卷期:24卷1、2期合刊(2010.12)
頁碼:36-43
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

目的:探討紅斑性狼瘡脊髓炎的臨床表現、治療、及癒後。方法:分析高雄長庚醫院1998至2009年間,收錄符合美國風濕病學會全身性紅斑性狼瘡準則,且須發生脊髓炎的病人為研究對象。共收錄10位全身性紅斑性狼瘡併脊髓炎病人。結果:本族群中,有80%病人為女姓,中位數年齡為39.5歲。臨床表現為,90%病人有感覺異常,80%病人有下肢無力,80%病人有括約肌功能障礙。30%病人先被診斷為尿道感染而住院。88%病人脊髓病灶於頸椎至上胸椎間。治療方式包括傳統高劑量類固醇、脈衝類固醇、cyclophosphamide、血漿置換,60%病人癒後不佳。五位病人治療方式中,包含了cyclophosphamide,其中60%得到較好的癒後。結論:全身性紅斑性狼瘡患者,發生脊髓炎時,常表現解尿困難徵狀,而以尿道感染的診斷來住院。而最常出現病灶的位置為頸椎至上胸椎。治療方面,高劑量類固醇併用cyclophosphamide可能有較好的癒後。
Objective: Myelitis is a rare but severe neurologic presentation of patients with systemic lupus erythematosus (SLE). Few large-scale retrospective cohort studies have been conducted, especially in Taiwan; therefore, we designed a retrospective study to investigate the disease parameters, treatment, and prognosis of myelitis in southern Taiwan. Methods: We reviewed medical records of patients with SLE who were evaluated at the Chang Gung Memorial Hospital-Kaohsiung Medical Center between January 1998 and January 2009. A total of 10 patients with myelopathy were included in the study. Neurologic variables and serologic features of SLE were assessed. Magnetic resonance images (MRI) of the spine and cerebrospinal fluid profiles were collected. We also analyzed the treatment and outcome of myelitis. Results: The cohort of 10 patients included 8 females (80%) and 2 males (20%). Three patients (30%) were initially admitted under the tentative impression of urinary tract infection (UTI). In 8 patients diagnosed with myelitis using MRI, 7 patients (88%) had increased T2 MRI signal intensity over the cervical and upper thoracic spinal area. Treatment regimens included conventional high-dose glucocorticoid, pulse methylprednisolone, cyclophosphamide, and plasma exchange. Six patients (60%) had a poor outcome. Additional cyclophosphamide was used in 5 patients and 3 of them (60%) had a good outcome. Conclusion: SLE patients, who contracted myelitis, presented with possible urinary difficulty and were admitted under the tentative impression of UTI. Besides, the most frequent site of lupus myelitis is the cervical to upper thoracic spinal area. Treatment with high-dose glucocorticoid and cyclophosphamide may be related to a better outcome compared to those without using cyclophosphamide.


    

本卷期目次
Formosan Journal of Rheumatology 24卷1、2期合刊 (2010.12)
Increased serum IFN-γ in women with a history of repeated implantation failures after in vitro fertilization and embryo transfer/ Wei-Ting HungYi-Ming ChenMing-Jer ChenDer-Yuan ChenJoung-Liang LanHsin-Hua Chen
Pott's disease-a retrospective study of 35 patients/ Chun-Kai ChiuYu-Jih SuHan-Ming LaiChung-Jen ChenTien-Tsai Cheng
Is antiphospholipid antibody related to outcome of lupus nephritis?-A 2-year analysis/ Wen-Chan ChiuShun-Chen HuangChung-Jen ChenChung-Yuan HsuTsong-Shing YangChing-Lan ChouFu-Mei SuYu-Jih SuShan-Fu YuChun-Kai ChiuYing-Chou ChenHan-Ming LaiTien-Tsai Cheng
Prognostic factors of survival in patients with dermatomyositis and polymyositis/ Hsiao-Chun ChangYeong-Jian Jan WuShue-Fen LuoHuei-Huang HoLieh-Bang LiouJi-Yih ChenWen-Pin TsaiChang-Fu KuoChung-Han YangI-Jung ChenKuang-Hui Yu
Myelitis in patients with systemic lupus erythematosus/ Chung-Yuan HsuWen-Chan ChiuTsong-Shing YangChing-Lan ChouYu-Jih SuShan-Fu YuChun-Kai ChiuYing-Chou ChenHan-Ming LaiTien-Tsai ChengChung-Jen Chen
Outcome of lupus nephritis-A 5-year analysis/ Tsong-Shing YangShun-Chen HuangChung-Jen ChenChung-Yuan HsuWen-Chan ChiuChing-Lan ChouFu-Mei SuYu-Jih SuShan-Fu YuChun-Kai ChiuYing-Chou ChenHan-Ming LaiTien-Tsai Cheng
Association of high sensitivity C-reactive protein with hyperuricemia in Taiwanese patients with gout/ Ming-Han ChenWei-Sheng ChenHui-Ting LeeChang-Youh TsaiChung-Tei Chou
Angiopoietin-1 and endoglin are not associated with pulmonary arterial hypertension in patients with systemic lupus erythematous/ Ling-Jung YenHsiu-Man KengChin-Chang ChengJiung-Jun ChuChieh-Mei HsuXin-Tian LinJui-Cheng TsengJui-Chieh HuLing-Ying Lu
Metabolic syndrome in patients with rheumatoid arthritis: association of lifestyle with anthropometric measurements/ Ming-Fu ChenYi-Ming ChenDer-Yuan ChenJoung-Liang Lan
Ruptured Baker's cyst in patients with rheumatic diseases: analysis of 235 Baker's cysts in 198 patients/ Song-Feng YehDeh-Ming ChangJenn-Haung LaiChen-Hung ChenTsung-Yun HouSan-Yuan KuoChi-Sheng ChiouChi-Ching Chang
Clinical and serological features of patients with anti-Jo-1 antibodies/ Ting-Hui ChangSong-Chou HsiehChia-Li Yu
Distinct MHC class Ⅰ and class Ⅱ alleles in Taiwanese patients with ankylosing spondylitis/ Bao-Bao HsuMing-Chi LuKuo-Liang YangKuang-Yung HuangChien-Hsueh TungSu-Qin LiuNing-Sheng Lai
Sonographic findings of Weber Christian disease involving the breasts: a case report/ Kuang-Yung HuangYi-Ming ChenDer-Yuan ChenHsin-Hua Chen
Refractory chylothorax in a patient with systemic lupus erythematosus: case report/ Bao-Bao HsuChien-Hsueh TungMing-Chi LuKuang-Yung HuangNing-Sheng Lai
Multicentric reticulohistiocytosis mimicking rheumatoid arthritis in a 35-year-old woman-case report/ Chyou-Shen LeeMei-Eng TuTien-Ling Chen
"Hide-bound" bowel sign in a patient with progressive systemic sclerosis and chronic intestinal pseudo-obstruction/ Pei-Chen Hsu
 
   
 
   

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