以舞蹈症为主要表现的系统性红斑狼疮1例报告

A report of one case of systemic lupus erythematosus with chorea as the main manifestation

目的分析以舞蹈症为主要表现的系统性红斑狼疮(SLE)患儿的临床特征、诊断和治疗。方法回顾性分析1例以舞蹈症为主要表现的SLE患儿的临床表现、辅助检查及诊治经过,并结合相关文献进行分析。结果患儿以舞蹈样动作为主诉入院,查体及相关的实验室检查发现患儿有多系统受累(贫血、蛋白尿、皮肤黏膜病损及舞蹈症),结合既往溶血性贫血病史,抗核抗体系列及抗心磷脂抗体阳性和头部磁共振成像(MRI)多灶病变,明确诊断为SLE、狼疮性脑病。经丙种球蛋白、糖皮质激素、阿立哌唑等药物治疗,症状缓解。结论寻找舞蹈症的病因时应注意SLE的可能性。

Objectives To analyze the clinical characteristics,diagnosis and treatment of systemic lupus erythematosus（SLE） with chorea as the main manifestation. Methods The clinical manifestations,laboratory examinations and treatment of one pediatric patient with main presentation as chorea diagnosed with SLE in the year of 2014 were studied. The related literatures were reviewed. Result A 14 years old female,was admitted with the main complaint of choreatic movements. The physical examination and laboratory tests indicated multi-system involvements（anemia,proteinuria,skin and mucous membrane damage and chorea）. Combined with history of hemolytic anemia,positive antinuclear,anti-doublestranded（ds） DNA and anti-cardiolipin（a CL） antibodies,and multiple lesions in magnetic resonance imaging（MRI） scan,the diagnosis of SLE and NPSLE was confirmed. After the treatment of gamma globulin,methylprednisolone,and Aripiprazole,the symptoms were relieved. ConclusionSLE should be considered as a possible cause of chorea.