Serum lymphocytotoxic antibodies and neurocognitive function in systemic lupus erythematosus

Article Abstract:

Systemic lupus erythematosus (SLE) is a long-term inflammatory disease of connective tissue, affecting the skin, joints, kidneys, nervous system, and mucous membranes. The disease is associated with the production of abnormal immune system proteins called autoantibodies, which attack normal body tissues. Lymphocytotoxic antibodies, autoantibodies that are toxic to lymphocytes (white blood cells), have been associated with complications of the central nervous system in SLE. Central nervous system or neuropsychiatric abnormalities in SLE include psychosis; hemiparesis, or paralysis of one side of the body; chorea, a nervous condition characterized by involuntary muscle twitching of the face and limbs; paresthesia, or numbness, tingling or prickling sensations; and mood changes. The relation between lymphocytotoxic antibodies and neuropsychiatric disorders in SLE (NP-SLE) was assessed in 98 women with SLE. Fifty patients had NP-SLE and 54 patients had impaired intellectual function. Twenty-four of the cognitively impaired patients had no evidence of NP-SLE. Lymphocytotoxic antibodies were detected in 32 percent of patients with NP-SLE, 23 percent of patients without NP-SLE, and these antibodies were related to cognitive impairment. There was no relation between lymphocytotoxic antibodies and disease affecting other organ systems, suggesting that the relation between lymphocytotoxic antibodies and neuropsychiatric disorders in SLE is specific. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Autoantibodies, Neurologic manifestations of general diseases, Neurologic manifestations

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Magnetic resonance and computed tomographic imaging in the evaluation of acute neuropsychiatric disease in systemic lupus erythematosus

Article Abstract:

Magnetic resonance imaging (MRI) uses electromagnetic energy to provide images of internal structures such as the brain. Computed tomography (CT), an X-ray technique, produces detailed images of structures in a selected plane of tissue by blurring images of structures in all other planes. These methods are useful in evaluating systemic lupus erythematosus (SLE) associated with central nervous system disorders. SLE, or simply lupus, is a long- term inflammatory disease of connective tissue, affecting the skin, joints, kidneys, nervous system, and mucous membranes. MRI and CT were used to assess 21 patients with lupus and various neuropsychiatric symptoms, including headache, seizures, and psychosis. CT identified two cases of diffuse atrophy (widespread wasting of tissue), one case of cerebral infarct (deterioration of brain tissue due to cessation of blood supply), and one case of hemorrhage within the brain. MRI detected eight cases of edema, or fluid accumulation in the brain, ten cases of infarct, one case of hemorrhage, seven cases of atrophy, and two cases of acute sinusitis, the inflammation of passages within the brain. Edema was characterized by lesions in various portions of the brain, which resolved after corticosteroid treatment. Some lesions detected by MR were not identified by CT, and MRI was useful in monitoring therapy. The findings show that MRI may be more effective in evaluating neuropsychiatric SLE than CT. (Consumer Summary produced by Reliance Medical Information, Inc.)

Brain, Magnetic resonance imaging, Central nervous system diseases, Tomography

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