Guillain-Barre 증후군과 뇌경색 양상을 보인 신경정신 루푸스 = A Case of Neuropsychiatric Lupus Presenting as Guillain-Barre Syndrome and Cerebral Infarction

다국어 초록 (Multilingual Abstract)

Systemic lupus erythematosus (SLE) is a disease of unknown etiology in which tissues and cells damaged by pathogenic autoantibodies and immune complexes. Nervous system involvement in patients with SLE encompasses a wide spectrum of neurologic and psychiatric features and the frequency of neuropsychiatric manifestations has been estimated at around 25% to 70%. American College of Rheumatology Ad Hoc Committee on neuropsychiatric lupus nomenclature developed case definitions for 19 different neuropsychiatric manifestations observed in SLE in 1999. Among them, Guillain-Barre syndrome and cerebral infarction are very rare neuropsychiatric manifestation. We experienced a 28-year-old woman with neuropsychiatric lupus which presented as Guillain-Barre syndrome and cerebral infarction. She was recovered after treatment with intravenous immunoglobulin, high dose methylprednisolone, cyclophosphamide and anticoagulants.

참고문헌 (Reference)

1 "successful treatment with monthly oral pulse cyclophosphamide" 1518-9, jrheumatol1989

2 "Systemic lupus erythematosus and acute demyelinating polyneuropathy" 33 : 1074-7, 1994

3 "Role of intravenous cyclophosphamide in the treatment severe neuropsychiatric systemic lupus erythematosus" 98 : 32-41, 1995

4 "Randomized trial of plasma exchange intravenous immunoglobulin and combined treatments in Guillain Barre Syndrome" 349 : 225-230, 1997

5 "On disease of the skin including the exanthemata" 14-47, 1875

6 "Neuropsychiatric manifestation in systemic lupus erythematosus:Prevalence and association with antiphospholipid antibodies" 30 : 985-992, 2003

7 "Neurofilament antibodies in systemic lupus erythematosus" 13 : 69-73, 1986

8 "Methylprednisolone pulse therapy for SLE patients with CNS disorder" 34 : 733-43, 1994

9 "Interleukin-1 and interleukin-6 activities are increased in cerebrospinal fluid of patients with CNS lupus erythematosus and correlate with local late T-cell activation marker" 1 : 111-7, 1992

10 "Controversies in lupus:nervous system involvement" 54 : 159-167, 1995

11 "Clinical and neuropathological findings in sytemic lupus erythematosus The role of vasculitis" 380-4,

12 "Cerebrov-ascular disease and antiphospholipid antibodies in systemic lupus erythematosus lupus like disease" 391-9, amjmed1989

13 "Cerebrospinal fluid and the choroid plexus during acute immune complex disease" 13 : 413-25, 1979

14 "Case definition for neuropsychiatric syndromes in systemic lupus erythematosus" 42 : 599-608, 1999

15 "Adams and Vitor's Principles of Neurology" McGraw-Hill 1380-1387, 2000

16 "Acute and chronic demyelinating inflammatory polyrad-iculopathy" 43 : 604-8, 1986

17 "A randomized trial comparing intravenous immunoglobulin and plasma exchange in Guillain-Barre syndrome" 326 : 1123-6, 1992