系统性红斑狼疮并发带状疱疹性脊髓炎

A case of systemic lupus erythematosus with herpes zoster myelitis

报告1例系统性红斑狼疮并发带状疱疹性脊髓炎。患者女,42岁。右上肢、肩背疼痛无力及群集性水疱5 d,有系统性红斑狼疮病史10年,长期服用泼尼松及甲氨蝶呤。体格检查:右侧睑裂较左侧偏小,右眼瞳孔直径2.5 mm,左眼瞳孔直径3.5mm.右侧肩部、项部、上肢及右侧手掌大鱼际可见带状分布的红斑、群集性水疱。头颅及颈椎磁共振成像检查:颈3、4、5节段脊髓肿胀,长T1、长T2信号,累计右侧为主。给予阿昔洛韦、甲泼尼龙、甘露醇等治疗,4个月后基本痊愈。

A case of systemic lupus erythematosus complicated by herpes zoster myelitis was reported. A 42-year-old woman experienced pain, weakness and clusters of vesicles on the right shoulder, neck and arm for 5 days. In last 10 years she suf- fered from systemic lupus erythematosus and received prednisone and methotrexate treatments. Physical examination： the right eye fissure was smaller than left, right eye pupil was 2.5 mm in diameter and left eye pupil was 3.5 ram. There were clusters of vesicles and zonal distribution of erythema on the fight shoulder, neck, arm and thenar. Magnetic resonance images of cranial and cervical spine showed the third, fourth, fifth sections of cervical spinal cord swelling with long T1 and long T2, mainly on the right side. Satisfactory results were obtained after combination treatments of acyclovir, methylprednisolone and mannitol.