전신성 홍반성 낭창의 신경계 침범에 관한 임상적 고찰

Abstract

Systemrc lupus erythematosus (SLE) is an autoimmune, inflammatory, chronic disorder characterized by multiorgan involvement including the nervous system. The neurologic manifestations of SLE vary in clinical signs and clinical course. We recently reviewed medical records of 198 patients with SLE who had been admitted to Severance hospital between 1980 and 1990 to see neurological features with the relationship of non-neurological features of SLE and prognosis. Among 198 cases with SLE sixty-seven patients (33.8%) had significant neurologic and/or psychiatric manifestations dunng the course of their disease. CNS lupus was found in 48 cases and symptoms were seizure, mental deterioration, psychiatric manifestations and focal neurologic deficit in decreasing order of frequency. Myelopathy was noted in 4, peripheral neuropathy in 5, and rline patients developed myopathy. Eight had typical meningitis ;four of these patients had aseptic meningitis, three had tuberculous meningitis, and one had bacterial meningitis. In half of the patients with CNS lupus, the neurologic symptoms occurred during the first one year of their illness. Other major organs such as the kidney, heart, lung, skin and joints were more commonly affected in CNS lupus. The prognosis of CNS lupus is relatively poor, especially in patients with seizure which is followed by altered mentality.