疑似为病毒性脑炎的Sneddon综合征一例

A case of Sneddon syndrome misdiagnosed as viral encephalitis

Sneddon综合征是一种罕见的疾病,可导致脑血管疾病和皮肤症状的反复发生。该例患者为青年女性,起病时临床表现及辅助检查结果提示病毒性脑炎,之后反复出现了神经功能缺损症状及皮肤广泛网状青斑,且头部MR T2加权成像表现为皮质下白质多发高信号,诊断为Sneddon综合征。给予激素和抗栓药物治疗后,症状好转,随访3个月无复发。与既往报道的Sneddon综合征不同,该患者起病时症状疑似病毒性脑炎,颅内大血管受累。因此,临床医师对该类情况,应进一步行脑血管影像学检查,并注意与Sneddon综合征鉴别,如病程中出现了网状青斑则需明确Sneddon综合征的诊断。

Sneddon syndrome is a rare disease that can cause recurrence of cerebrovascular diseases and skin symptoms.This case was a middle-aged female patient with clinical manifestations and examination results at the time of onset supporting viral encephalitis.Afterwards,the patient manifested recurrent symptoms of neurological deficit and livedo racemosa.Cranial MR T2-weighted imaging showed multiple hyperintensity in the subcortical white matter,and the diagnosis was Sneddon syndrome.After hormone and antithrombotic treatment,her symptoms improved.There was no symptom recurrence at 3-month follow-up.Unlike previously reported cases of Sneddon syndrome,this patient had symptoms mimicking viral encephalitis at onset with large intracranial vessels involved.Therefore,clinicians should conduct further cerebro vascular imaging examinations for such cases,and distinguish it from Sneddon syndrome.If livedo racemosa appears during the course of disease,Sneddon syndrome can be diagnosed.