[Severe Interstitial Lung Disease and Manic Symptoms Secondary to Corticosteroids in a Patient with Systemic Lupus Erythematosus and Secondary Sjögren's Syndrome].
Identifieur interne : 000C83 ( Main/Exploration ); précédent : 000C82; suivant : 000C84[Severe Interstitial Lung Disease and Manic Symptoms Secondary to Corticosteroids in a Patient with Systemic Lupus Erythematosus and Secondary Sjögren's Syndrome].
Auteurs : Sofia Silvério Serra ; Teresa Pedrosa ; Sandra Falcão ; Jaime Cunha BrancoSource :
- Acta medica portuguesa [ 1646-0758 ] ; 2017.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Femelle, Glucocorticoïdes (effets indésirables), Glucocorticoïdes (usage thérapeutique), Humains, Indice de gravité médicale, Lupus érythémateux disséminé (), Lupus érythémateux disséminé (traitement médicamenteux), Pneumopathies interstitielles (), Prednisolone (effets indésirables), Prednisolone (usage thérapeutique), Syndrome de Gougerot-Sjögren (étiologie), Trouble bipolaire ().
- MESH :
- effets indésirables : Glucocorticoïdes, Prednisolone.
- traitement médicamenteux : Lupus érythémateux disséminé.
- usage thérapeutique : Glucocorticoïdes, Prednisolone.
- étiologie : Syndrome de Gougerot-Sjögren.
- Adulte d'âge moyen, Femelle, Humains, Indice de gravité médicale, Lupus érythémateux disséminé, Pneumopathies interstitielles, Trouble bipolaire.
English descriptors
- KwdEn :
- Bipolar Disorder (chemically induced), Female, Glucocorticoids (adverse effects), Glucocorticoids (therapeutic use), Humans, Lung Diseases, Interstitial (chemically induced), Lupus Erythematosus, Systemic (complications), Lupus Erythematosus, Systemic (drug therapy), Middle Aged, Prednisolone (adverse effects), Prednisolone (therapeutic use), Severity of Illness Index, Sjogren's Syndrome (etiology).
- MESH :
- chemical , adverse effects : Glucocorticoids, Prednisolone.
- chemically induced : Bipolar Disorder, Lung Diseases, Interstitial.
- complications : Lupus Erythematosus, Systemic.
- drug therapy : Lupus Erythematosus, Systemic.
- etiology : Sjogren's Syndrome.
- chemical , therapeutic use : Glucocorticoids, Prednisolone.
- Female, Humans, Middle Aged, Severity of Illness Index.
Abstract
Interstitial lung disease occurs in up to 25% of patients with Sjögren's syndrome and 2% - 8 % of patients with systemic lupus erythematosus. Corticosteroid therapy remains the main treatment for systemic lupus erythematosus. However, it can be associated with several neuropsychiatric disorders especially with prednisolone at a dose of more than 40 mg/day. We present the case of a 51-year-old patient with systemic lupus erythematosus and secondary Sjögren's syndrome with severe pulmonary involvement four years after the diagnosis. Chest computed tomography revealed neofibrosis and ground glass appearance pattern. After increasing the dose of prednisolone to 60 mg/day, the patient presented a manic episode. There was need of hospitalization and the situation was considered to be secondary to corticosteroids at high doses. Central neurological involvement by organic disease was excluded. We introduced monthly perfusion of cyclophosphamide for six months and later started mycophenolate mofetil 2 g/day, reducing prednisolone to 10 mg/day and maintaining hydroxychloroquine 400 mg/day, with control of disease activity.
DOI: 10.20344/amp.7297
PubMed: 28550835
Affiliations:
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Le document en format XML
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Hospital de Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal.</nlm:affiliation><wicri:noCountry code="no comma">Serviço de Reumatologia. Hospital de Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal.</wicri:noCountry></affiliation></author><author><name sortKey="Pedrosa, Teresa" sort="Pedrosa, Teresa" uniqKey="Pedrosa T" first="Teresa" last="Pedrosa">Teresa Pedrosa</name><affiliation><nlm:affiliation>Serviço de Reumatologia. Hospital de Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal. CEDOC. NOVA Medical School/Faculdade de Ciências Médicas. Universidade NOVA de Lisboa. Lisboa. Portugal.</nlm:affiliation><wicri:noCountry code="no comma">Serviço de Reumatologia. Hospital de Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal. CEDOC. NOVA Medical School/Faculdade de Ciências Médicas. Universidade NOVA de Lisboa. Lisboa. Portugal.</wicri:noCountry></affiliation></author><author><name sortKey="Falcao, Sandra" sort="Falcao, Sandra" uniqKey="Falcao S" first="Sandra" last="Falcão">Sandra Falcão</name><affiliation><nlm:affiliation>Serviço de Reumatologia. Hospital de Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal. CEDOC. NOVA Medical School/Faculdade de Ciências Médicas. Universidade NOVA de Lisboa. Lisboa. Portugal.</nlm:affiliation><wicri:noCountry code="no comma">Serviço de Reumatologia. Hospital de Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal. CEDOC. NOVA Medical School/Faculdade de Ciências Médicas. Universidade NOVA de Lisboa. Lisboa. Portugal.</wicri:noCountry></affiliation></author><author><name sortKey="Branco, Jaime Cunha" sort="Branco, Jaime Cunha" uniqKey="Branco J" first="Jaime Cunha" last="Branco">Jaime Cunha Branco</name><affiliation><nlm:affiliation>Serviço de Reumatologia. Hospital de Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal. CEDOC. NOVA Medical School/Faculdade de Ciências Médicas. Universidade NOVA de Lisboa. Lisboa. Portugal.</nlm:affiliation><wicri:noCountry code="no comma">Serviço de Reumatologia. Hospital de Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal. CEDOC. NOVA Medical School/Faculdade de Ciências Médicas. Universidade NOVA de Lisboa. Lisboa. Portugal.</wicri:noCountry></affiliation></author></analytic><series><title level="j">Acta medica portuguesa</title><idno type="eISSN">1646-0758</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Bipolar Disorder (chemically induced)</term><term>Female</term><term>Glucocorticoids (adverse effects)</term><term>Glucocorticoids (therapeutic use)</term><term>Humans</term><term>Lung Diseases, Interstitial (chemically induced)</term><term>Lupus Erythematosus, Systemic (complications)</term><term>Lupus Erythematosus, Systemic (drug therapy)</term><term>Middle Aged</term><term>Prednisolone (adverse effects)</term><term>Prednisolone (therapeutic use)</term><term>Severity of Illness Index</term><term>Sjogren's Syndrome (etiology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Femelle</term><term>Glucocorticoïdes (effets indésirables)</term><term>Glucocorticoïdes (usage thérapeutique)</term><term>Humains</term><term>Indice de gravité médicale</term><term>Lupus érythémateux disséminé ()</term><term>Lupus érythémateux disséminé (traitement médicamenteux)</term><term>Pneumopathies interstitielles ()</term><term>Prednisolone (effets indésirables)</term><term>Prednisolone (usage thérapeutique)</term><term>Syndrome de Gougerot-Sjögren (étiologie)</term><term>Trouble bipolaire ()</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Glucocorticoids</term><term>Prednisolone</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Bipolar Disorder</term><term>Lung Diseases, Interstitial</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Lupus Erythematosus, Systemic</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Lupus Erythematosus, Systemic</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Glucocorticoïdes</term><term>Prednisolone</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Sjogren's Syndrome</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Glucocorticoids</term><term>Prednisolone</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Lupus érythémateux disséminé</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Glucocorticoïdes</term><term>Prednisolone</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Syndrome de Gougerot-Sjögren</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Female</term><term>Humans</term><term>Middle Aged</term><term>Severity of Illness Index</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Indice de gravité médicale</term><term>Lupus érythémateux disséminé</term><term>Pneumopathies interstitielles</term><term>Trouble bipolaire</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Interstitial lung disease occurs in up to 25% of patients with Sjögren's syndrome and 2% - 8 % of patients with systemic lupus erythematosus. Corticosteroid therapy remains the main treatment for systemic lupus erythematosus. However, it can be associated with several neuropsychiatric disorders especially with prednisolone at a dose of more than 40 mg/day. We present the case of a 51-year-old patient with systemic lupus erythematosus and secondary Sjögren's syndrome with severe pulmonary involvement four years after the diagnosis. Chest computed tomography revealed neofibrosis and ground glass appearance pattern. After increasing the dose of prednisolone to 60 mg/day, the patient presented a manic episode. There was need of hospitalization and the situation was considered to be secondary to corticosteroids at high doses. Central neurological involvement by organic disease was excluded. We introduced monthly perfusion of cyclophosphamide for six months and later started mycophenolate mofetil 2 g/day, reducing prednisolone to 10 mg/day and maintaining hydroxychloroquine 400 mg/day, with control of disease activity.</div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Branco, Jaime Cunha" sort="Branco, Jaime Cunha" uniqKey="Branco J" first="Jaime Cunha" last="Branco">Jaime Cunha Branco</name><name sortKey="Falcao, Sandra" sort="Falcao, Sandra" uniqKey="Falcao S" first="Sandra" last="Falcão">Sandra Falcão</name><name sortKey="Pedrosa, Teresa" sort="Pedrosa, Teresa" uniqKey="Pedrosa T" first="Teresa" last="Pedrosa">Teresa Pedrosa</name><name sortKey="Serra, Sofia Silverio" sort="Serra, Sofia Silverio" uniqKey="Serra S" first="Sofia Silvério" last="Serra">Sofia Silvério Serra</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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