Doença intersticial pulmonar grave e mania induzida por corticosteróides em doente com lúpus eritematoso sistémico e síndrome de Sjögren secundária

Translated title of the contribution: Severe interstitial lung disease and manic symptoms secondary to corticosteroids in a patient with systemic lupus erythematosus and secondary Sjögren’s syndrome

Sofia Silvério Serra, Teresa Pedrosa, Sandra Falcão, Jaime Branco

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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.

Original languagePortuguese
Pages (from-to)246-250
Number of pages5
JournalActa medica portuguesa
Volume30
Issue number3
DOIs
Publication statusPublished - 1 Mar 2017

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Interstitial Lung Diseases
Systemic Lupus Erythematosus
Adrenal Cortex Hormones
Prednisolone
Mycophenolic Acid
Hydroxychloroquine
Cyclophosphamide
Glass
Hospitalization
Thorax
Perfusion
Tomography
Lung
Therapeutics

Keywords

  • Adrenal cortex hormones/adverse effects
  • Interstitial
  • Lung diseases
  • Lupus erythematosus
  • Mental disorders/ chemically induced
  • Sjögren’s syndrome
  • Systemic

Cite this

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abstract = "Interstitial lung disease occurs in up to 25{\%} of patients with Sj{\"o}gren’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 Sj{\"o}gren’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.",
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