Case report on aseptic meningitis of three patients with mixed connective tissue disease

混合性結合組織病(MCTD)の精神神経症状として,三叉神経障害はよく知られている. 1978年, Bennett1)は, MCTDに合併した4例の無菌性髄膜炎を報告している.われわれはここに,無菌性髄膜炎を合併した, 3例のMCTDを報告する. 3例とも女性で, Raynaud現象,手指の腫脹,リンパ節腫脹,筋肉痛,関節痛があり,抗nRNP抗体単独陽性であった. 2症例はMCTDと診断され外来経過観察中,無菌性髄膜炎を発症した.症例3は,無菌性髄膜炎の発症によりMCTDの確定診断がついた.臨床症状は発熱と頭痛が主で,症例3のみ,髄膜刺激症状が認められた.髄液所見は,初圧の上昇,単核球優位の細胞増加,蛋白増加あり,糖,クロールは正常であった. 3例とも, 50～60mg/日のプレドニソロン(PSL)によく反応し,髄膜炎症状は軽快した. MCTDの髄膜炎につき, SLEのそれと比較して考察する.

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