Patient with both lupus anticoagulant and acute disseminated encephalomyelitis.
We present the unusual case of 16-year-old girl who developed intractable convulsions five days after the onset of a cold. Meningeal signs, lymphopenia, proteinuria, and lupus anticoagulant were also present. Treatment with anticonvulsants, antituberculous agents, and adenine arabinoside were ineffective. The initiation of methylprednisolone pulse therapy immediately resolved convulsions and fever. The diagnosis, suggested by the clinical course and the marked improvement of the meningoencephalitis by pulse therapy, was an encephalitic form of acute disseminated encephalomyelitis. Clinical and laboratory findings indicated that an immune disorder may have triggered an abnormal response to a viral infection leading to this patient's neurologic disorder.
First Department of Internal Medicine, Nerima-Hikarigaoka Hospital, Japan.
Y
Y
Matsukawa
T
T
Mizutani
N
N
Kitamura
M
M
Takei
T
T
Hayama
S
S
Nishinarita
T
T
Horie
S
S
Sawada
A
A
Tagusagawa
M
M
Tsuchiya
T
T
Takasu
D000208:Acute Disease; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D004679:Encephalomyelitis / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000032:analysis*; D008775:Methylprednisolone / Q000627:therapeutic use; D012640:Seizures / Q000209:etiology
D000893:Anti-Inflammatory Agents; D016682:Lupus Coagulation Inhibitor; D008775:Methylprednisolone