[Severe Interstitial Lung Disease and Manic Symptoms Secondary to Corticosteroids in a Patient with Systemic Lupus Erythematosus and Secondary Sjögren's Syndrome].
Identifieur interne : 000160 ( PubMed/Corpus ); précédent : 000159; suivant : 000161[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.
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
Links to Exploration step
pubmed:28550835Le document en format XML
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Portugal.</nlm:affiliation></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></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></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:28550835</idno><idno type="pmid">28550835</idno><idno type="doi">10.20344/amp.7297</idno><idno type="wicri:Area/PubMed/Corpus">000160</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000160</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">[Severe Interstitial Lung Disease and Manic Symptoms Secondary to Corticosteroids in a Patient with Systemic Lupus Erythematosus and Secondary Sjögren's Syndrome].</title><author><name sortKey="Serra, Sofia Silverio" sort="Serra, Sofia Silverio" uniqKey="Serra S" first="Sofia Silvério" last="Serra">Sofia Silvério Serra</name><affiliation><nlm:affiliation>Serviço de Reumatologia. Hospital de Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal.</nlm:affiliation></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></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></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></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="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="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" xml:lang="en"><term>Female</term><term>Humans</term><term>Middle Aged</term><term>Severity of Illness Index</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><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28550835</PMID><DateCompleted><Year>2018</Year><Month>05</Month><Day>30</Day></DateCompleted><DateRevised><Year>2018</Year><Month>10</Month><Day>23</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1646-0758</ISSN><JournalIssue CitedMedium="Internet"><Volume>30</Volume><Issue>3</Issue><PubDate><Year>2017</Year><Month>Mar</Month><Day>31</Day></PubDate></JournalIssue><Title>Acta medica portuguesa</Title><ISOAbbreviation>Acta Med Port</ISOAbbreviation></Journal><ArticleTitle>[Severe Interstitial Lung Disease and Manic Symptoms Secondary to Corticosteroids in a Patient with Systemic Lupus Erythematosus and Secondary Sjögren's Syndrome].</ArticleTitle><Pagination><MedlinePgn>246-250</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.20344/amp.7297</ELocationID><Abstract><AbstractText>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.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Serra</LastName><ForeName>Sofia Silvério</ForeName><Initials>SS</Initials><AffiliationInfo><Affiliation>Serviço de Reumatologia. Hospital de Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisboa. Portugal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pedrosa</LastName><ForeName>Teresa</ForeName><Initials>T</Initials><AffiliationInfo><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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Falcão</LastName><ForeName>Sandra</ForeName><Initials>S</Initials><AffiliationInfo><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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Branco</LastName><ForeName>Jaime Cunha</ForeName><Initials>JC</Initials><AffiliationInfo><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.</Affiliation></AffiliationInfo></Author></AuthorList><Language>por</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><VernacularTitle>Doença Intersticial Pulmonar Grave e Mania Induzida por Corticosteróides em Doente com Lúpus Eritematoso Sistémico e Síndrome de Sjögren Secundária.</VernacularTitle><ArticleDate DateType="Electronic"><Year>2017</Year><Month>03</Month><Day>31</Day></ArticleDate></Article><MedlineJournalInfo><Country>Portugal</Country><MedlineTA>Acta Med Port</MedlineTA><NlmUniqueID>7906803</NlmUniqueID><ISSNLinking>0870-399X</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D005938">Glucocorticoids</NameOfSubstance></Chemical><Chemical><RegistryNumber>9PHQ9Y1OLM</RegistryNumber><NameOfSubstance UI="D011239">Prednisolone</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D001714" MajorTopicYN="N">Bipolar Disorder</DescriptorName><QualifierName UI="Q000139" MajorTopicYN="Y">chemically induced</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005938" MajorTopicYN="N">Glucocorticoids</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017563" MajorTopicYN="N">Lung Diseases, Interstitial</DescriptorName><QualifierName UI="Q000139" MajorTopicYN="Y">chemically induced</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008180" MajorTopicYN="N">Lupus Erythematosus, Systemic</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011239" MajorTopicYN="N">Prednisolone</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012859" MajorTopicYN="N">Sjogren's Syndrome</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading></MeshHeadingList><OtherAbstract Type="Publisher" Language="por"><AbstractText>A doença intersticial pulmonar ocorre em até cerca de 25% dos doentes com síndrome de Sjögren e em 2% - 8% dos doentes com lúpus eritematoso sistémico. Os corticosteróides permanecem como pilar de tratamento do lúpus eritematoso sistémico mas podem associar-se a complicações neuropsiquiátricas, sobretudo com doses de prednisolona superiores a 40 mg/dia. Apresentamos o caso de uma doente de 51 anos com síndrome depressiva, lúpus eritematoso sistémico e síndrome de Sjögren secundária que desenvolveu envolvimento pulmonar grave evidente quatro anos após o diagnóstico, com tomografia computadorizada de tórax a revelar padrão de neofibrose e vidro despolido. Com o aumento da prednisolona para 60 mg/dia a doente iniciou um quadro maníaco com necessidade de internamento e que foi admitido no contexto de corticoterapia em dose elevada. Foi excluído envolvimento neurológico central por doença orgânica. Iniciou ciclofosfamida endovenosa mensal durante seis meses seguida de micofenolato de mofetil, tendo-se reduzido prednisolona até 10 mg/dia e mantido hidroxicloroquina 400 mg/dia, com controlo da atividade da doença.</AbstractText></OtherAbstract></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>12</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2016</Year><Month>09</Month><Day>12</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>5</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>5</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2018</Year><Month>5</Month><Day>31</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28550835</ArticleId><ArticleId IdType="doi">10.20344/amp.7297</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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