학술논문
Balancing immunosuppression and infection: recurrent enterovirus encephalitis in SLE.
Document Type
Academic Journal
Author
Cheema S; Neurology, Brighton and Sussex University Hospitals NHS Trust, Haywards Heath, UK sanjay.cheema@nhs.net.; Bunting E; Neurology, National Hospital for Neurology and Neurosurgery, London, UK.; Good C; Neuroradiology, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.; Hajela V; Rheumatology, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.; Ridha BH; Neurology, Brighton and Sussex University Hospitals NHS Trust, Haywards Heath, UK.; Saha RA; Neurology, Brighton and Sussex University Hospitals NHS Trust, Haywards Heath, UK.
Source
Publisher: BMJ Pub. Group Country of Publication: England NLM ID: 101130961 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1474-7766 (Electronic) Linking ISSN: 14747758 NLM ISO Abbreviation: Pract Neurol Subsets: MEDLINE
Subject
Language
English
Abstract
A young woman with systemic lupus erythematosus (SLE) developed recurrent enterovirus meningoencephalitis while taking prednisolone, azathioprine and rituximab. After reducing the immunosuppression, she developed a central nervous system (CNS) flare of SLE, with enterovirus still present in the cerebrospinal fluid (CSF). There are no evidence-based specific treatments for enterovirus encephalitis, but she responded well to intravenous immunoglobulin alongside pulsed methylprednisolone and rituximab. This case highlights the difficulties in managing people with co-existing infective and autoimmune conditions, especially if each affects the CNS. A viral infection and SLE flare can resemble one another clinically, although here the radiological differentiation of CNS lupus versus enterovirus encephalitis helped to guide the diagnosis.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)