精神症状の発現に一致して髄液中のインターフェロンアルファーとインターロイキン6が高値を示した全身性エリテマトーデスの1例

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In March 1990, a 19-year-old woman developed facial erythema. In May, when she came to the Kawasaki Municipal Hospital, she was found to have leukopenia (2, 800/mm3), high titer of anti-nuclear antibodies (2, 560×) and anti-SSA and SSB antibodies. In September, anti-U 1 RNP antibody and in December, anti-Sm antibody appeared for the first time respectively. In January 1991, she developed depression and she was admitted in February. She had akinesis, convulsion, involuntary movement of tongue. She was diagnosed as systemic lupus erythematosus complicated with central nervous system involvement (CNS lupus). She was treated with steroid pulse therapy and monthly intravenous cyclophosphamide injection and left the hospital in May. In June, anti-Sm antibody was negative but in August, it appeared again. In September 1991, she was readmitted because of mania. She had no convulsion at this time. Interferon-α(INFα) and interleukin-6 (IL-6) in cerebro-spinal fluid (CSF) were measured on admittion and after steroid pulse therapy. The levels of these cytokines were elevated (INFα346IU/ml, IL-6 680 pg/ml) and decreased before improvement of psychic symptoms. Measurement of CSF INFα and IL-6 seemed to be useful in diagnosing the CNS lupus and predicting the response to the treatment.
日本臨床免疫学会の論文