BRAIN and NERVE－神経研究の進歩74巻5号

2022年05月発行

増大特集 次の一手—神経筋疾患難治例をどのように治療するか

ステロイド抵抗性の中枢神経サルコイドーシス—早期からの多剤併用の必要性

著者： 藤澤美和子¹ 神田隆²

所属機関： ¹山口県立総合医療センター脳神経内科 ²山口大学医学部神経・筋難病治療学講座

ページ範囲：P.455 - P.461

文献概要

サルコイドーシスの標準治療薬はステロイドであるが，中枢神経サルコイドーシスはステロイド抵抗性で，治療に難渋することが多い。特に水頭症を伴う場合はステロイド単独での寛解は困難である。そのため，早期から免疫抑制薬，TNF-α阻害薬の併用を検討すべきである。高齢患者では，薬の副作用による感染症や臓器障害へ特に注意し，早期から他剤併用により高用量・長期のステロイド使用を避けることが重要である。

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