NPSLEの臨床—脳神経内科の立場から

Neuropsychiatric Systemic Lupus Erythematosus: From the Standpoint of Department of Neurology

全身性エリテマトーデス（SLE）に伴って見られる神経精神症状（NPSLE）の表現型は多様である。SLEの初発症状としてNPSLEが出現し得るため，SLEと未診断の神経精神症状を呈する患者からSLEを見抜く必要がある。また，SLE患者が経過中に神経精神症状を呈した場合，SLEに起因するprimary NPSLEなのか，治療薬の副作用や他疾患によるものかを正確に判断することも治療方針決定に重要である。

Abstract

Neuropsychiatric manifestations in patients with systemic lupus erythematosus (SLE), termed neuropsychiatric SLE (NPSLE), encompass a wide variety of neurological and psychiatric characteristics. A neuropsychiatric event may precede an SLE diagnosis; therefore, physicians must screen for SLE in patients presenting with neuropsychiatric symptoms, if they are not already diagnosed with this condition. For assessing patients with SLE who present with neuropsychiatric symptoms, it is important to first determine whether the symptoms are caused by SLE (primary NPSLE), whether they are a complication of a therapy, or whether they are caused by other comorbidities. Accurate attribution of neuropsychiatric symptoms is vital for selecting therapeutic interventions.