北部風濕病醫(yī)學會月會

1、北部風濕病醫(yī)學會月會時 間：98年10月10日 (星期六) 14:0016:00地 點：臺大醫(yī)院國際會議中心 402 D室臺北市中正區(qū)徐州路2號3樓主辦單位：臺大醫(yī)院 風濕免疫科 TimeTopicSpeaker14:00-14:10Opening余家利 主任14:10-14:40Leukoencephalopathy as the initial presentation of late onset lupus張婷惠 醫(yī)師14:40-15:40Neuromyelitis optica in systemic lupus erythematosus沈玠妤 醫(yī)師杜昀真 醫(yī)師15:40-16:00

2、Discussion余家利 主任Leukoencephalopathy as the initial presentation oflate onset lupus a case report張婷惠 醫(yī)師臺大醫(yī)院 風濕免疫科 This 79-year-old woman had been in relatively good health except hypertension under medical treatment. She presented in Feb 2009 with three months history of weakness on her right side ex

3、tremities. She was brought to our neurology department due to dysarthria. The magnetic resonance imaging (MRI) of brain disclosed diffuse hyperintense white matter lesions. Subsequent studies established the diagnosis of systemic lupus erythematosus (SLE) with neurological involvement.Neuropsychiatr

4、ic (NP) involvement is a frequent and potentially serious manifestation in SLE patients. In addition to the history and physical examination, other diagnostic approaches include serologic tests and analysis of cerebrospinal fluid. However, NPSLE may occur in the absence of markers for active disease

5、. The role of MRI in diagnosis and management of NPSLE was reviewed. Neuromyelitis optica in systemic lupus erythematosus沈玠妤 醫(yī)師, 杜昀真 醫(yī)師臺大醫(yī)院 風濕免疫科Neuromyelitis optica (NMO) or Devics syndrome is a rare inflammatory disorder of CNS in SLE. It seldom happens as the first clinical manifestation of SLE.

6、We reported two cases and the literatures are reviewed thereafter. The first case was a 35-year-old female without systemic disease. She complained about bilateral blurred vision and then rapid progressed to vision loss in 3 days. Bilateral hand numbness also accompanied. She visited our hospital wh

7、ere VEP and brain MRI confirmed optic neuritis. Spine MRI disclosed myelitis. Series of examination including autoimmune profile showed SLE related neurological disorder. Methylprednisolone and cyclophosphamide pulse therapy were given and her symptoms improved. However, disease relapsed again few m

8、onths later. Another few courses of steroid and cyclophosphamide pulse therapy were given again and her blurred vision improved. The second case was a 38-year-old woman diagnosed as SLE in her early twenties with initial presentation with lupus nephritis. She developed rapid deterioration of left eye visual acuity within 3 days. She was admitted to ophthalmology ward and optic neuritis was suspected. The VEP, brain MRI and brain perfusion scan revealed suspicious SLE with CNS involvement. There was no evidence of other major organ involvement. She received courses o