目的 探讨儿童系统性红斑狼疮(SLE)合并抗磷脂综合征(APS)及脑血栓的临床特点。方法 回顾1例 SLE合并APS及脑血栓患儿的临床资料,并复习相关文献。结果 患儿,男,12岁。病初反复发热、神志不清、面颊部皮疹, 有贫血及血小板减少,抗核抗体(ANA)及抗心磷脂抗体(aCL)阳性,磁共振成像示脑部多发梗死灶。明确诊断为SLE合 并APS及脑血栓。使用甲基泼尼松龙、环磷酰胺、华法林、美罗培南、阿昔洛韦等治疗,同时给予丙种球蛋白静滴。结论 SLE合并APS及脑血栓患儿病情较重,早期正确诊断、合理治疗可有效改善预后。
Objective To explore the clinical features of systemic lupus erythematosus (SLE) combined with antiphospholipid syndrome (APS) and cerebral thrombosis in a child. Method The clinical data of SLE combined with APS and cerebral thrombosis in a child was retrospectively analyzed, and the related literature was reviewed. Results This was a 12-year-old boy. The disease onset with recurrent fever, confusion and rash in cheek. He had anemia and thrombocytopenia, and positive antinuclear antibody (ANA) and anticardiolipin antibody (aCL). Magnetic resonance imaging showed multiple cerebral infarction. The diagnosis of SLE combined with APS and cerebral thrombosis was clearly made. Methylprednisolone, cyclophosphamide, warfarin, meropenem and acyclovir were used for the treatment. At the same time, the patient also received intravenous immunoglobulin. Conclusion SLE combined with APS and cerebral thrombosis in children was usually in a severe condition, the prognosis of which can be effectively improve by early diagnosis and reasonable treatment.