视神经脊髓炎谱系疾病、系统性红斑狼疮和胸腺瘤共病一例

A case of neuromyelitis optica spectrum disorders complicated with systemic lupus erythematosus and thymoma

一例53岁男性患者,因"右眼视力下降2个月,伴双下肢无力8 d"入院。胸椎增强MRI提示胸髓T3水平偏右侧信号异常,考虑脱髓鞘病变,血清水通道蛋白质4抗体阳性,效价为1∶320,诊断为视神经脊髓炎谱系疾病。该患者同时合并系统性红斑狼疮和胸腺瘤。经甲泼尼龙冲击、血浆置换、免疫抑制剂等治疗后,患者右眼视力及双下肢无力逐渐好转。

A 53-year-old male patient presented with hypopsia of his right eye for2 months and lower extremities weakness for 8 days. Thoracic MRI demonstrated a lesion at T3 level appearing as hyperintense on T2-weighted images with nonenhancement by contrast medium and demyelinating lesion was considered. Aquaporin-4-Ab was positive and the antibody titer was 1 ∶ 320 in serum. The diagnosis of neuromyelitis optica spectrum disorders was made. In addition, systemic lupus erythematosus and thymoma coexisted in this patient. After methylprednisolone impact treatment,plasma exchange and immunosuppressive therapy,the right vision and lower extremities weakness of the patient were improved.