Purpose
To study the frequency and the vascular cerebral pattern of central nervous system involvement in patients with neurolupus.
Background.
The prevalence of systemic lupus erythematosus (SLE) is up to 150/100.000,
depending principally on the gender and race (5-10 times more frequent in women and in Afro-Caribbean and Asian population) [1,
2].
The diagnostic of SLE is based on the American College of Rheumatology (ACR) diagnostic criteria,
requiring a minimum of 4 out of 11 [1].
Neurolupus has a prevalence of 14-90% of all the SLE...
Methods and Materials
Retrospective descriptive study.
We carried out a review of 40 patients with neurolupus,
studied by MRI during the last 7 years (2006-2012).
The MRI studies were performed using three different systems of 1,5 T and 3 T and included T1,
T2,
FLAIR sequences and in 10 patients also diffusion sequences.
The lesions were classified according to:
Distribution and anatomical location:
-Supratentorial:
periventricular white matter
deep white matter
corpus callosum
cortico-subcortical (great territory infarcts)
-Infratentorial:
spinal cord
brainstem
cerebellum
Number: unique,
double...
Results
The average age was 43 years (range 18 to 83).
Thirty-seven (92,5%) were women and 3 (7,5%) men.
We found cerebral anomalies in 14 patients (35%).
In this group the mean age was 43,7 years (range 27 to 66).
Of the 14 patients who had MRI findings,
9 (64,3%) presented with only supratentorial involvement,
4 (28,6%) had both supra and infratentorial lesions and 1 only infratentorial.
Of the 5 patients with infratentorial involvement,
the location of the lesions was: cerebellum in 3 patients,
brainstem in...
Conclusion
A non depreciative number of neurolupus patients have MRI findings,
the most frequent pattern being small supratentorial white matter lesions,
representing small vessel disease.
References
1.
Joseph FG,
Scolding NJ.
Neurolupus.
Pract Neurol.
2010;10:4-15.
2.
Katsumata Y,Harigai M,Kawaguchi Y,
et al.
Diagnostic reliability of magnetic resonance imaging for central nervous system syndromes in systemic lupus erythematosus: a prospective cohort study.
BMC Musculoskeletal Disorders.
2010;11-13.
3.
Appenzeller S,
Pike GB,
Clarke AE.
Magnetic resonance imaging in the evaluation of central nervous system manifestations in systemic lupus erythematosus.
Clin Rev Allergy Immunol.
2008;34:361-6.
Personal Information
Nicolae Sarbu - Radiology Department,
Hospital Clinic of Barcelona,
Spain;
[email protected]