Doença intersticial pulmonar grave e mania induzida por corticosteróides em doente com lúpus eritematoso sistémico e síndrome de Sjögren secundária
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.20344/amp.7297 |
Resumo: | 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. |
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Doença intersticial pulmonar grave e mania induzida por corticosteróides em doente com lúpus eritematoso sistémico e síndrome de Sjögren secundáriaSevere interstitial lung disease and manic symptoms secondary to corticosteroids in a patient with systemic lupus erythematosus and secondary Sjögren’s syndromeAdrenal cortex hormones/adverse effectsInterstitialLung diseasesLupus erythematosusMental disorders/ chemically inducedSjögren’s syndromeSystemicMedicine(all)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.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)Centro de Estudos de Doenças Crónicas (CEDOC)RUNSilvério Serra, SofiaPedrosa, TeresaFalcão, SandraBranco, Jaime2017-09-26T13:49:42Z2017-03-012017-03-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article5application/pdfhttps://doi.org/10.20344/amp.7297por0870-399XPURE: 3159110http://www.scopus.com/inward/record.url?scp=85016717220&partnerID=8YFLogxKhttps://doi.org/10.20344/amp.7297info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:11:54Zoai:run.unl.pt:10362/23613Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:27:51.100017Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Doença intersticial pulmonar grave e mania induzida por corticosteróides em doente com lúpus eritematoso sistémico e síndrome de Sjögren secundária Severe interstitial lung disease and manic symptoms secondary to corticosteroids in a patient with systemic lupus erythematosus and secondary Sjögren’s syndrome |
title |
Doença intersticial pulmonar grave e mania induzida por corticosteróides em doente com lúpus eritematoso sistémico e síndrome de Sjögren secundária |
spellingShingle |
Doença intersticial pulmonar grave e mania induzida por corticosteróides em doente com lúpus eritematoso sistémico e síndrome de Sjögren secundária Silvério Serra, Sofia Adrenal cortex hormones/adverse effects Interstitial Lung diseases Lupus erythematosus Mental disorders/ chemically induced Sjögren’s syndrome Systemic Medicine(all) |
title_short |
Doença intersticial pulmonar grave e mania induzida por corticosteróides em doente com lúpus eritematoso sistémico e síndrome de Sjögren secundária |
title_full |
Doença intersticial pulmonar grave e mania induzida por corticosteróides em doente com lúpus eritematoso sistémico e síndrome de Sjögren secundária |
title_fullStr |
Doença intersticial pulmonar grave e mania induzida por corticosteróides em doente com lúpus eritematoso sistémico e síndrome de Sjögren secundária |
title_full_unstemmed |
Doença intersticial pulmonar grave e mania induzida por corticosteróides em doente com lúpus eritematoso sistémico e síndrome de Sjögren secundária |
title_sort |
Doença intersticial pulmonar grave e mania induzida por corticosteróides em doente com lúpus eritematoso sistémico e síndrome de Sjögren secundária |
author |
Silvério Serra, Sofia |
author_facet |
Silvério Serra, Sofia Pedrosa, Teresa Falcão, Sandra Branco, Jaime |
author_role |
author |
author2 |
Pedrosa, Teresa Falcão, Sandra Branco, Jaime |
author2_role |
author author author |
dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Centro de Estudos de Doenças Crónicas (CEDOC) RUN |
dc.contributor.author.fl_str_mv |
Silvério Serra, Sofia Pedrosa, Teresa Falcão, Sandra Branco, Jaime |
dc.subject.por.fl_str_mv |
Adrenal cortex hormones/adverse effects Interstitial Lung diseases Lupus erythematosus Mental disorders/ chemically induced Sjögren’s syndrome Systemic Medicine(all) |
topic |
Adrenal cortex hormones/adverse effects Interstitial Lung diseases Lupus erythematosus Mental disorders/ chemically induced Sjögren’s syndrome Systemic Medicine(all) |
description |
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. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-09-26T13:49:42Z 2017-03-01 2017-03-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.20344/amp.7297 |
url |
https://doi.org/10.20344/amp.7297 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
0870-399X PURE: 3159110 http://www.scopus.com/inward/record.url?scp=85016717220&partnerID=8YFLogxK https://doi.org/10.20344/amp.7297 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
5 application/pdf |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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