Magnetic resonance imaging of central nervous system lesions in patients with lupus erythematosus. Correlation with clinical remission and antineurofilament and anticardiolipin antibody titers

Clinical, magnetic resonance imaging (MRI), and serologic studies were performed on 11 patients with diffuse central nervous system (CNS) systemic lupus erythematosus and 8 patients with focal CNS lupus. MRI of patients with diffuse clinical disease showed symmetrically distributed areas of increase...

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Bibliographic Details
Published in:Arthritis and rheumatism 1991-04, Vol.34 (4), p.432-441
Main Authors: Bell, Carolyn L., Robbins, Mark, Graziano, Frank, Partington, Curtis, Turski, Patrick, Kornguth, Steven
Format: Article
Language:English
Subjects:
Adult
Autoantibodies - metabolism
Biological and medical sciences
Blood Coagulation Factors - immunology
Blood Coagulation Factors - metabolism
Brain - pathology
Brain Diseases - diagnosis
Brain Diseases - drug therapy
Brain Diseases - immunology
Cardiolipins - immunology
Female
Humans
Intermediate Filaments - immunology
Lupus Coagulation Inhibitor
Lupus Erythematosus, Systemic - diagnosis
Lupus Erythematosus, Systemic - drug therapy
Lupus Erythematosus, Systemic - immunology
Magnetic Resonance Imaging
Medical sciences
Methylprednisolone - therapeutic use
Remission Induction
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
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Summary:Clinical, magnetic resonance imaging (MRI), and serologic studies were performed on 11 patients with diffuse central nervous system (CNS) systemic lupus erythematosus and 8 patients with focal CNS lupus. MRI of patients with diffuse clinical disease showed symmetrically distributed areas of increased signal intensity in the subcortical white matter; these resolved after treatment with high‐dose methylprednisolone. These patients' sera contained elevated levels of antineurofilament antibodies. Patients with focal CNS lupus had areas of increased signal intensity and atrophic changes in regions corresponding to the major cerebral vessels. These MRI abnormalities did not improve after treatment with high‐dose steroids. The sera of patients with focal CNS lupus had elevated levels of cardiolipin and lupus anticoagulant but normal levels of antineurofilament antibody. Our findings suggest that results of a combined clinical, MRI, and serologic evaluation of patients with CNS lupus may predict the response of patients to high‐dose steroid therapy.
ISSN:0004-3591
1529-0131
DOI:10.1002/art.1780340408