Recurrent Neurological Episodes for 10 Years Preceding Skin Lesions in Neuro-Sweet Disease
An absence of skin lesions at the neurological onset may obscure the diagnosis of neuro-Sweet disease (NSD). We herein report a 32-year-old man with NSD in whom neurological symptoms preceded the development of skin lesions by 10 years. The patient exhibited four distinct neurological episodes: meni...
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| Veröffentlicht in: | Internal Medicine 2019/12/01, Vol.58(23), pp.3469-3472 |
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| creator | Hiraga, Akiyuki Ozaki, Daisuke Oikawa, Makiko Araki, Nobuyuki Kuwabara, Satoshi |
| description | An absence of skin lesions at the neurological onset may obscure the diagnosis of neuro-Sweet disease (NSD). We herein report a 32-year-old man with NSD in whom neurological symptoms preceded the development of skin lesions by 10 years. The patient exhibited four distinct neurological episodes: meningoencephalitis, scattered brain lesions, ocular flutter, and isolated seizures. Acute relapses responded to corticosteroid therapy, and the patient was successfully maintained on corticosteroid and dapsone combination therapy. NSD should be considered in the differential diagnosis of patients with recurrent neurological manifestations, especially with both meningeal and brain parenchymal involvement, even if no skin lesions are observed. |
| doi_str_mv | 10.2169/internalmedicine.2821-19 |
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We herein report a 32-year-old man with NSD in whom neurological symptoms preceded the development of skin lesions by 10 years. The patient exhibited four distinct neurological episodes: meningoencephalitis, scattered brain lesions, ocular flutter, and isolated seizures. Acute relapses responded to corticosteroid therapy, and the patient was successfully maintained on corticosteroid and dapsone combination therapy. NSD should be considered in the differential diagnosis of patients with recurrent neurological manifestations, especially with both meningeal and brain parenchymal involvement, even if no skin lesions are observed.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.2821-19</identifier><identifier>PMID: 31327825</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>Administration, Oral ; Adrenal Cortex Hormones - administration & dosage ; Adult ; Anti-Infective Agents - administration & dosage ; Case Report ; corticosteroid ; Corticosteroids ; dapson ; Dapsone ; Dapsone - administration & dosage ; Diagnosis, Differential ; Diaminodiphenylsulfone ; Differential diagnosis ; Diplopia - drug therapy ; Diplopia - etiology ; Drug Administration Schedule ; Drug Therapy, Combination ; Gait Disorders, Neurologic - drug therapy ; Gait Disorders, Neurologic - etiology ; Humans ; Infusions, Intravenous ; Internal medicine ; Lesions ; Male ; Meningoencephalitis ; Meningoencephalitis - drug therapy ; Meningoencephalitis - etiology ; Methylprednisolone - administration & dosage ; Nervous System Diseases - diagnosis ; Nervous System Diseases - etiology ; neuro-Sweet disease ; Nystagmus, Pathologic - drug therapy ; Nystagmus, Pathologic - etiology ; Prednisolone - administration & dosage ; Recurrence ; Seizures ; Seizures - drug therapy ; Seizures - etiology ; Skin diseases ; Skin Diseases - pathology ; skin eruption ; Skin lesions ; Sweet Syndrome - complications ; Sweet Syndrome - diagnosis ; Sweet's disease ; Sweet's syndrome</subject><ispartof>Internal Medicine, 2019/12/01, Vol.58(23), pp.3469-3472</ispartof><rights>2019 by The Japanese Society of Internal Medicine</rights><rights>Copyright Japan Science and Technology Agency 2019</rights><rights>Copyright © 2019 by The Japanese Society of Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c667t-f27d87a8721a9015422ef25306315f346fde1596a9667eb2af2c73d9b2933a4e3</citedby><cites>FETCH-LOGICAL-c667t-f27d87a8721a9015422ef25306315f346fde1596a9667eb2af2c73d9b2933a4e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928507/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928507/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,1883,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31327825$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hiraga, Akiyuki</creatorcontrib><creatorcontrib>Ozaki, Daisuke</creatorcontrib><creatorcontrib>Oikawa, Makiko</creatorcontrib><creatorcontrib>Araki, Nobuyuki</creatorcontrib><creatorcontrib>Kuwabara, Satoshi</creatorcontrib><title>Recurrent Neurological Episodes for 10 Years Preceding Skin Lesions in Neuro-Sweet Disease</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>An absence of skin lesions at the neurological onset may obscure the diagnosis of neuro-Sweet disease (NSD). We herein report a 32-year-old man with NSD in whom neurological symptoms preceded the development of skin lesions by 10 years. The patient exhibited four distinct neurological episodes: meningoencephalitis, scattered brain lesions, ocular flutter, and isolated seizures. Acute relapses responded to corticosteroid therapy, and the patient was successfully maintained on corticosteroid and dapsone combination therapy. NSD should be considered in the differential diagnosis of patients with recurrent neurological manifestations, especially with both meningeal and brain parenchymal involvement, even if no skin lesions are observed.</description><subject>Administration, Oral</subject><subject>Adrenal Cortex Hormones - administration & dosage</subject><subject>Adult</subject><subject>Anti-Infective Agents - administration & dosage</subject><subject>Case Report</subject><subject>corticosteroid</subject><subject>Corticosteroids</subject><subject>dapson</subject><subject>Dapsone</subject><subject>Dapsone - administration & dosage</subject><subject>Diagnosis, Differential</subject><subject>Diaminodiphenylsulfone</subject><subject>Differential diagnosis</subject><subject>Diplopia - drug therapy</subject><subject>Diplopia - etiology</subject><subject>Drug Administration Schedule</subject><subject>Drug Therapy, Combination</subject><subject>Gait Disorders, Neurologic - drug therapy</subject><subject>Gait Disorders, Neurologic - etiology</subject><subject>Humans</subject><subject>Infusions, Intravenous</subject><subject>Internal medicine</subject><subject>Lesions</subject><subject>Male</subject><subject>Meningoencephalitis</subject><subject>Meningoencephalitis - drug therapy</subject><subject>Meningoencephalitis - etiology</subject><subject>Methylprednisolone - administration & dosage</subject><subject>Nervous System Diseases - diagnosis</subject><subject>Nervous System Diseases - etiology</subject><subject>neuro-Sweet disease</subject><subject>Nystagmus, Pathologic - drug therapy</subject><subject>Nystagmus, Pathologic - etiology</subject><subject>Prednisolone - administration & dosage</subject><subject>Recurrence</subject><subject>Seizures</subject><subject>Seizures - drug therapy</subject><subject>Seizures - etiology</subject><subject>Skin diseases</subject><subject>Skin Diseases - pathology</subject><subject>skin eruption</subject><subject>Skin lesions</subject><subject>Sweet Syndrome - complications</subject><subject>Sweet Syndrome - diagnosis</subject><subject>Sweet's disease</subject><subject>Sweet's syndrome</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkUFvEzEQhS0EomnhLyBLXLhsscfx2r4goVIKUkQRhQNcLMc7mzps7NTeBfHvcZoSQbmMLfmb92b8CKGcnQJvzcsQR8zRDRvsgg8RT0EDb7h5QGZczE2jQMiHZMYM1w3UckSOS1kzJrQy8JgcCS5AaZAz8u0T-ilnjCP9gFNOQ1oF7wZ6vg0ldVhon3K1pV_R5UI_ZvTVMq7o1fcQ6QJLSLHQer1tbq5-Io70TSjoCj4hj3o3FHx6d56QL2_PP5-9axaXF-_PXi8a37ZqbHpQnVZOK-DOMC7nANiDFKwVXPZi3vYdcmlaZyqOS3A9eCU6swQjhJujOCGv9rrbaVk_xNddshvsNoeNy79scsH--xLDtV2lH7Y1oCVTVeDFnUBONxOW0W5C8TgMLmKaigVoudHcMFnR5_fQdZp2SVRKADMSNGeV0nvK51RKxv4wDGd2F6C9H6DdBWi5qa3P_l7m0PgnsQpc7oF1Gd0KD4DLY_AD_q8sdR3ttu4tDqS_dtliFL8BFDC5ew</recordid><startdate>20191201</startdate><enddate>20191201</enddate><creator>Hiraga, Akiyuki</creator><creator>Ozaki, Daisuke</creator><creator>Oikawa, Makiko</creator><creator>Araki, Nobuyuki</creator><creator>Kuwabara, Satoshi</creator><general>The Japanese Society of Internal Medicine</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20191201</creationdate><title>Recurrent Neurological Episodes for 10 Years Preceding Skin Lesions in Neuro-Sweet Disease</title><author>Hiraga, Akiyuki ; Ozaki, Daisuke ; Oikawa, Makiko ; Araki, Nobuyuki ; Kuwabara, Satoshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c667t-f27d87a8721a9015422ef25306315f346fde1596a9667eb2af2c73d9b2933a4e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Administration, Oral</topic><topic>Adrenal Cortex Hormones - administration & dosage</topic><topic>Adult</topic><topic>Anti-Infective Agents - administration & dosage</topic><topic>Case Report</topic><topic>corticosteroid</topic><topic>Corticosteroids</topic><topic>dapson</topic><topic>Dapsone</topic><topic>Dapsone - administration & dosage</topic><topic>Diagnosis, Differential</topic><topic>Diaminodiphenylsulfone</topic><topic>Differential diagnosis</topic><topic>Diplopia - drug therapy</topic><topic>Diplopia - etiology</topic><topic>Drug Administration Schedule</topic><topic>Drug Therapy, Combination</topic><topic>Gait Disorders, Neurologic - drug therapy</topic><topic>Gait Disorders, Neurologic - etiology</topic><topic>Humans</topic><topic>Infusions, Intravenous</topic><topic>Internal medicine</topic><topic>Lesions</topic><topic>Male</topic><topic>Meningoencephalitis</topic><topic>Meningoencephalitis - drug therapy</topic><topic>Meningoencephalitis - etiology</topic><topic>Methylprednisolone - administration & dosage</topic><topic>Nervous System Diseases - diagnosis</topic><topic>Nervous System Diseases - etiology</topic><topic>neuro-Sweet disease</topic><topic>Nystagmus, Pathologic - drug therapy</topic><topic>Nystagmus, Pathologic - etiology</topic><topic>Prednisolone - administration & dosage</topic><topic>Recurrence</topic><topic>Seizures</topic><topic>Seizures - drug therapy</topic><topic>Seizures - etiology</topic><topic>Skin diseases</topic><topic>Skin Diseases - pathology</topic><topic>skin eruption</topic><topic>Skin lesions</topic><topic>Sweet Syndrome - complications</topic><topic>Sweet Syndrome - diagnosis</topic><topic>Sweet's disease</topic><topic>Sweet's syndrome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hiraga, Akiyuki</creatorcontrib><creatorcontrib>Ozaki, Daisuke</creatorcontrib><creatorcontrib>Oikawa, Makiko</creatorcontrib><creatorcontrib>Araki, Nobuyuki</creatorcontrib><creatorcontrib>Kuwabara, Satoshi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hiraga, Akiyuki</au><au>Ozaki, Daisuke</au><au>Oikawa, Makiko</au><au>Araki, Nobuyuki</au><au>Kuwabara, Satoshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Recurrent Neurological Episodes for 10 Years Preceding Skin Lesions in Neuro-Sweet Disease</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2019-12-01</date><risdate>2019</risdate><volume>58</volume><issue>23</issue><spage>3469</spage><epage>3472</epage><pages>3469-3472</pages><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>An absence of skin lesions at the neurological onset may obscure the diagnosis of neuro-Sweet disease (NSD). We herein report a 32-year-old man with NSD in whom neurological symptoms preceded the development of skin lesions by 10 years. The patient exhibited four distinct neurological episodes: meningoencephalitis, scattered brain lesions, ocular flutter, and isolated seizures. Acute relapses responded to corticosteroid therapy, and the patient was successfully maintained on corticosteroid and dapsone combination therapy. NSD should be considered in the differential diagnosis of patients with recurrent neurological manifestations, especially with both meningeal and brain parenchymal involvement, even if no skin lesions are observed.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>31327825</pmid><doi>10.2169/internalmedicine.2821-19</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Administration, Oral Adrenal Cortex Hormones - administration & dosage Adult Anti-Infective Agents - administration & dosage Case Report corticosteroid Corticosteroids dapson Dapsone Dapsone - administration & dosage Diagnosis, Differential Diaminodiphenylsulfone Differential diagnosis Diplopia - drug therapy Diplopia - etiology Drug Administration Schedule Drug Therapy, Combination Gait Disorders, Neurologic - drug therapy Gait Disorders, Neurologic - etiology Humans Infusions, Intravenous Internal medicine Lesions Male Meningoencephalitis Meningoencephalitis - drug therapy Meningoencephalitis - etiology Methylprednisolone - administration & dosage Nervous System Diseases - diagnosis Nervous System Diseases - etiology neuro-Sweet disease Nystagmus, Pathologic - drug therapy Nystagmus, Pathologic - etiology Prednisolone - administration & dosage Recurrence Seizures Seizures - drug therapy Seizures - etiology Skin diseases Skin Diseases - pathology skin eruption Skin lesions Sweet Syndrome - complications Sweet Syndrome - diagnosis Sweet's disease Sweet's syndrome |
| title | Recurrent Neurological Episodes for 10 Years Preceding Skin Lesions in Neuro-Sweet Disease |
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