Cefaleia unilateral contínua por lúpus eritematoso sistêmico: relato de caso
DOI:
https://doi.org/10.48208/HeadacheMed.2024.9Palavras-chave:
Headache, Unilateral cephalalgia, Systemic lupus erythematosus, Corticosteroid therapy , InflammationResumo
Background
Hemicrania continua is a rare form of cephalalgia featuring a chronic and persistent headache in only one side of the head.
Objectives
In this report, we present a case of a patient with hemicrania continua and systemic lupus erythematosus (SLE).
Methods
We collected patient data through the electronic medical record. Afterward, we reviewed the literature regarding hemicrania continua and its pathophysiology and correlation with neurovascular alterations, inflammation, and SLE.
Results
A 42-year-old woman visited the emergency department due to worsening constant unilateral cephalalgia that had been present for the past 6 months. The patient reported a highly intense (10/10) headache in the entire left hemicrania that radiated to the left shoulder. During physical examination, she presented with nystagmus, vertigo, and aggravated cephalalgia associated to body movement and, despite having no optic nerve thickening. In addition, she had jaundice, tachycardia, and splenomegaly. Complimentary exams found deep anemia, depletion in complement system and anti-nuclear factors, suggesting a possible hemolytic anemia (AIHA) due to SLE. Treatment was initiated with hydrocortisone and prednisone, associated with amitriptyline, fluoxetine and diazepam, reaching full remission. These syndromes have aggravated each other, and possibly the explanation for the cephalalgia remission was the control of AIHA and SLE. It features a rare case in literature and thus warrants discussion.
Downloads
Referências
Schytz HW, Amin FM, Selb J, Boas DA. Non-invasive methods for measuring vascular changes in neurovascular
headaches. Journal of Cerebral Blood Flow & Metabolism. 2017;39(4):633-49.Doi 10.1177/0271678x17724138 DOI: https://doi.org/10.1177/0271678X17724138
Kursun O, Yemisci M, van den Maagdenberg AMJM, H. Migraine and neuroinflammation: the
inflammasome perspective. The Journal of Headache and Pain. 2021;22(1).Doi 10.1186/s10194-021-01271-1
Dodick DW. Migraine. The Lancet. 2018;391(10127):1315-30.Doi 10.1016/s0140-6736(18)30478-1 DOI: https://doi.org/10.1016/S0140-6736(18)30478-1
Kass J, Mizrahi E. Neurology Secrets: Sixth Edition2016.1-531 p.
Aringer M. EULAR/ACR classification criteria for SLE.Seminars in Arthritis and Rheumatism. 2019;49(3):S14-S7. Doi 10.1016/j.semarthrit.2019.09.009 DOI: https://doi.org/10.1016/j.semarthrit.2019.09.009
Calabrò RS, Casella C, Militi D, Raciti G, Raciti L.Chronic Migraine: A Narrative Review on the Use of Botulinum Toxin with Clinical Indications and FutureDirections. Journal of Integrative Neuroscience. 2022;21(5).Doi 10.31083/j.jin2105141 DOI: https://doi.org/10.31083/j.jin2105141
Trysberg E, Nylen K, Rosengren LE, Tarkowski A. Neuronal and astrocytic damage in systemic
lupus erythematosus patients with central nervous system involvement. Arthritis & Rheumatism. 2003;48(10):28817.Doi 10.1002/art.11279
Pietrobon D. Migraine: New Molecular Mechanisms. The Neuroscientist. 2016;11(4):373-86.Doi DOI: https://doi.org/10.1177/1073858405275554
1177/1073858405275554
9. Osorio-Toro LM, Quintana-Ospina JH, MeloBurbano LÁ, Ruiz-Jiménez PA, Daza-Arana JE, RivasTafurt GP, et al. Autoimmune Hemolytic Anemia Caused by Cold Agglutinin Antibodies in Systemic Lupus erythematosus—a Rare Association: Case Report. Journal of Blood Medicine. 2023;Volume 14:507-11.Doi 10.2147/jbm.S420937 DOI: https://doi.org/10.2147/JBM.S420937
Neuropsychiatric Manifestations in Systemic Lupus Erythematosus Patients at a Tertiary Hospital in Peru. European Journal of Rheumatology. 2023;10(4):143- DOI: https://doi.org/10.5152/eurjrheum.2023.22095
Doi 10.5152/eurjrheum.2023.22095
Vecchia D, Pietrobon D. Migraine: a disorder of brain excitatory–inhibitory balance? Trends in Neurosciences. 2012;35(8):507-20.Doi 10.1016/j.tins.2012.04.007 DOI: https://doi.org/10.1016/j.tins.2012.04.007
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2024 Mr. Teixeira, Prof. Dr. Roriz Cruz (Author)
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.