ウイルス性髄膜炎で発症した全身性エリテマトーデス(SLE)が疑われる一症例

抄録

A patient, a 21 years old woman, had been admitted into our department due to coma with fever. After her admission, she was diagnosed as having viral meningitis based on the nuchal stiffness, flaccid paralysis of her four extremities, abnormal findings of the CSF, i.e. increase of pressure and of mononuclear cell count, and high seral anti-influenza A virus titer. She recovered leaving no trace of psychoneurological disturbance after corticoid therapy. But, thereafter, increased ESR and hypergammaglobulinemia persisted, and besides, antinuclear antibody and anti-DNA antibody as well as Raynaud's phenomenon appeared. Moreover, negative PPD skin reaction and decreased peripheral lymphocyte and active T cell count were observed.
Although, these findings might have been partially induced by the viral infection itself, the course of the patient suggested a preexistent latent SLE with immunodefficiency, particularly that of cell-mediated immunity, and the incidence of the influenza A virus infection might be related to the immunodefficiency antecedent to the probable SLE.
Any reports on the viral meningitis concomitant with SLE can not yet be found in the literature, except for only one reporting a viral meningitis due to herpes virus complicating SLE.