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浙江大学学报（医学版）
浙江大学学报（医学版）  2018, Vol. 47 Issue (1): 71-74    DOI: 10.3785/j.issn.1008-9292.2018.02.10
病例报告     
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
周海金1(),夏萍2,*(),胡兴越2
1. 温岭市第一人民医院神经内科, 浙江 台州 317500
2. 浙江大学医学院附属邵逸夫医院神经内科, 浙江 杭州 310016
A case of neuromyelitis optica spectrum disorders complicated with systemic lupus erythematosus and thymoma
ZHOU Haijin1(),XIA Ping2,*(),HU Xingyue2
1. Department of Neurology, the First People's Hospital of Wengling, Taizhou 317500, Zhejiang Province, China
2. Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
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摘要：

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。
关键词： 神经系统自身免疫疾病/治疗;  视神经脊髓炎/诊断;  水通道蛋白质4;  红斑狼疮, 系统性/诊断;  红斑狼疮, 系统性/治疗;  胸腺瘤/治疗;  病例报告    
Abstract:

A 53-year-old male patient presented with hypopsia of his right eye for 2 months and lower extremities weakness for 8 days. Thoracic MRI demonstrated a lesion at T3 level appearing as hyperintense on T2-weighted images with non-enhancement 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.
Key words: Autoimmune diseases of the nervous system/therapy    Neuromyelitis optica/diagnosis    Aquaporin 4    Lupus erythematosus, systemic/diagnosis    Lupus erythematosus, systemic/therapy    Thymoma/therapy    Case reports
收稿日期: 2017-09-10 出版日期: 2018-06-12
CLC:  R593.2  
基金资助: 浙江省自然科学基金(LQ15H090002)
通讯作者: 夏萍     E-mail: zhouhaijinabc@126.com;xiaping01062@163.com
作者简介: 周海金(1983-), 男, 硕士, 主治医师, 主要从事神经病学研究; E-mail:zhouhaijinabc@126.com; https://orcid.org/0000-0002-3458-0803
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引用本文:

周海金,夏萍,胡兴越. 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[J]. 浙江大学学报（医学版）, 2018, 47(1): 71-74.

ZHOU Haijin,XIA Ping,HU Xingyue. A case of neuromyelitis optica spectrum disorders complicated with systemic lupus erythematosus and thymoma. J Zhejiang Univ (Med Sci), 2018, 47(1): 71-74.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2018.02.10    或    http://www.zjujournals.com/med/CN/Y2018/V47/I1/71

图 1  胸椎MRI普通扫描和增强扫描图像
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