Zaburzenia psychiczne w toczniu rumieniowatym układowym

Bogaczewicz, Anna; Sobów, Tomasz; Bogaczewicz, Jarosław; Ząbek, Jakub; Bieńkowski, Przemysław; Kowalski, Jan; Robak, Ewa; Sysa-Jędrzejowska, Anna; Woźniacka, Anna

Journal

Aktualności Neurologiczne

2013 | 13 | 3 | 168–178

Article title

Zaburzenia psychiczne w toczniu rumieniowatym układowym

Authors

Anna Bogaczewicz , Tomasz Sobów , Jarosław Bogaczewicz , Jakub Ząbek , Przemysław Bieńkowski , Jan Kowalski , Ewa Robak , Anna Sysa-Jędrzejowska , Anna Woźniacka

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168-178 Neurologia 3_2013_Bogaczewicz_Zaburzenia.pdf

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Mental disorder in systemic lupus erythematosus

Languages of publication

Abstracts

Toczeń rumieniowaty układowy (systemic lupus erythematosus, SLE) jest chorobą tkanki łącznej, rozwijającą się na podłożu autoimmunizacji. Objawy kliniczne SLE są związane z występowaniem nie tylko wykwitów skórnych, ale również dolegliwości ze strony narządów wewnętrznych, a także zaburzeń hematologicznych oraz o charakterze neuropsychiatrycznym. Patogeneza NPSLE (neuropsychiatric systemic lupus erythematosus) jest złożona, próbuje się ją wyjaśniać wytwarzaniem autoprzeciwciał oraz odkładaniem się kompleksów immunologicznych, czego następstwem jest cytotoksyczne uszkodzenie neuronów, jak również nieprawidłową ekspresją mediatorów zapalnych i napływem komórek zapalnych, zaburzeniami naczyniowymi i skłonnością do zakrzepów. Całkowita częstość występowania NPSLE jest szacowana na 56,3% pacjentów z SLE. Najczęściej występującymi zaburzeniami psychicznymi u chorych na toczeń rumieniowaty są zaburzenia nastroju, lękowe, poznawcze oraz świadomości. Istotnym aspektem są także polekowe zaburzenia psychiczne. W podejściu terapeutycznym wobec pacjentów z NPSLE o nieznacznej aktywności choroby i/lub nieznacznym stopniu zmian narządowych stosuje się glikokortykosteroidy w niskich dawkach oraz – w zależności od potrzeb – leki przeciwlękowe, przeciwdepresyjne, niekiedy kwas walproinowy, karbamazepinę, lamotryginę i preparaty przeciwpsychotyczne. W profilaktyce przeciwzakrzepowej u chorych z grupy ryzyka stosuje się kwas acetylosalicylowy.

The systemic lupus erythematosus (SLE) is a connective tissue disorder, being developed on the basis of the autoallergy. Clinical symptoms of SLE are connected not only with the occurrence of cutaneous exanthemata, but can also manifest itself with the row of symptoms on the part of internal organs, with haematologic distempers and symptoms about the neuropsychiatric character. The pathogenesis of neuropsychiatric systemic lupus erythematosus (NPSLE) is complicated and one tries to become clear her with the production of autoantibodies and with the postponement himself antigen–antibody complexes, what a succession is the cytotoxic damage of neurons, an irregular expression of inflammatory mediators and an influx of inflammatory cells, vascular distempers and an inclination to thrombuses. The entire frequency of the occurrence NPSLE is estimated on 56.3% patients with SLE. Most often mental disorders in patients with lupus erythematosus are mood disorder, anxiety disorder, cognitive disorders and consciousness clouding. An essential aspect there are also drug-induced mental trouble. In the therapeutic approach in the therapy of NPSLE about the slight activity of the disease and/or the slight degree of organ changes complies glucocorticoids in low doses and depending on needs medicines counterphobic, antidepressant, sometimes the valproic acid, the carbamazepine, the lamotrigine and anti-psychotic preparations. In the antithrombotic prophylaxis at ill from the risk population the acetylsalicylic acid complies.

Keywords

cognitive disorders mental disorders mood disorders neuropsychiatric systemic lupus erythematosus systemic lupus erythematosus toczeń neuropsychiatryczny toczeń rumieniowaty układowy zaburzenia
nastroju zaburzenia poznawcze zaburzenia psychiczne

Discipline

MEDICINE: MEDICINE

Publisher

Medical Communications

Journal

Aktualności Neurologiczne

Year

2013

Volume

Issue

Pages

168–178

Physical description

Contributors

author

Anna Bogaczewicz

anna.bogaczewicz@umed.lodz.pl

Zakład Psychologii Lekarskiej UM w Łodzi

author

Tomasz Sobów

Zakład Psychologii Lekarskiej UM w Łodzi

author

Jarosław Bogaczewicz

Klinika Dermatologii i Wenerologii UM w Łodzi

author

Jakub Ząbek

Zakład Mikrobiologii i Serologii Instytutu Reumatologii w Warszawie

author

Przemysław Bieńkowski

Instytut Psychiatrii i Neurologii, Wydział Farmakologii UM w Warszawie

author

Jan Kowalski

Klinika Chorób Wewnętrznych i Rehabilitacji Kardiologicznej UM w Łodzi

author

Ewa Robak

Klinika Dermatologii i Wenerologii UM w Łodzi

author

Anna Sysa-Jędrzejowska

Klinika Dermatologii i Wenerologii UM w Łodzi

author

Anna Woźniacka

Klinika Dermatologii i Wenerologii UM w Łodzi

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