Positron emission tomography and magnetic resonance imaging for cerebral involvement in patients with systemic lupus erythematosus |
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Authors: | M Sailer W Burchert C Ehrenheim H G O M Smid J Haas K Wildhagen U Wurster H Deicher |
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Institution: | (1) Department of Neurophysiology, Otto von Guericke University, Leipziger Strasse 44, D-39120 Magdeburg, Germany Tel.: +49 391/67 15031, Fax: +49 391/67 15032, e-mail: Michael.Sailer@Medizin.Uni-Magdeburg.de, DE;(2) Department of Nuclear Medicine, Medizinische Hochschule Hannover, Hannover, Germany, DE;(3) Division of Clinical Immunology, Department of Medicine, Medizinische Hochschule Hannover, Hannover, Germany, DE;(4) Department of Neurology, Medizinische Hochschule Hannover, Hannover, Germany, DE |
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Abstract: | Central nervous system (CNS) involvement in systemic lupus erythematosus (SLE) remains difficult to diagnose, particularly
since structural abnormalities may not be revealed by magnetic resonance imaging (MRI). Glucose utilisation was measured by
positron emission tomography (PET) in 35 SLE patients to detect signs of CNS involvement. The patients were examined by a
standardised neurological examination, a battery of tests to evaluate neuropsychological performance and MRI. Antineuronal
antibodies were determined to investigate their putative role in CNS involvement in SLE. Twenty patients had distinct neurological
(17) and/or psychiatric (3) symptoms. Ten patients had pronounced cognitive impairment. Neurological and cognitive deficits
were thus found to be unrelated disorders in SLE. Global glucose utilisation of SLE patients did not differ significantly
from that of normal controls, nor were differences found between SLE patients with or without neurological or cognitive abnormalities.
On MRI of the brain, the number and size of white matter lesions correlated with the presence of neurological deficits but
were unrelated to the severity of cognitive impairment. Within the normal range, lower global glucose utilisation tended towards
lower values with increasing number and size of white matter lesions. Patients with lesions larger than 8 mm also showed distinctly
increased IgG anticardiolipin antibody titres, whereas measuring antineuronal antibodies did not reveal any relation to the
variables investigated. We conclude that the demonstration of CNS lesions by MRI can contribute confirmatory evidence for
CNS involvement in SLE, but PET or the presence of antineuronal antibodies adds little if any information beyond that obtained
by clinical examination, neuropsychological testing, and MRI.
Received: 22 May 1996 Received in revised form: 15 October 1996 Accepted: 2 November 1996 |
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Keywords: | Systemic lupus erythematosus Central nervous system Cognitive deficits Antineuronal antibodies Magnetic resonance imaging Positron emission tomography |
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