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Query: UMLS:C0409974 (
lupus
)
22,386
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Neurologic manifestations, afflicting up to 70% of SLE patients, include psychosis, seizures, chorea, neuropathies, and stroke. MRI is useful in evaluation of
lupus
patients and several reports have documented
cerebral atrophy
or focal hyperintensities. We report an unusual MRI appearance in a 56-year-old woman with SLE, diagnosed on the basis of pleuritis, lymphopenia, anti-DNA antibodies, and neurologic involvement. She reported recent onset of Raynaud's phenomenon and generalized macular rash. She presented after two months of gradual deterioration with memory loss, flattened affect, dysphagia, dysarthria, anomia, and somnolence, without focal neurologic signs. Investigations included elevated ESR, reduced complement, normal CSF without oligoclonal bands, negative viral serology, normal hormone and vitamin levels, normal renal and hepatic function. Neuropsychologic testing showed widespread impairment (WAIS-R: FSIQ-63; WMS-69; DRS-98; RCPM-14; WAB AQ-78.8). CT was normal but MRI showed strikingly symmetric, confluent hyperintensities extensively involving cerebral and cerebellar white matter on T1 and T2 weighted scans. Basal ganglia and subependymal and subcortical white matter were spared. Treated with prednisone, the patient made a gradual, but incomplete, recovery. These MRI findings may reflect widespread vasculopathy or direct immunologic brain insult with or without immunologic blood-brain barrier disruption.
...
PMID:Dementia with leukoencephalopathy in systemic lupus erythematosus. 191 71
Four patients with central nervous system
lupus erythematosus
(SLE), were studied with nuclear magnetic resonance imaging (NMRI) and positron emission tomography (PET) to assess cerebral blood flow and glucose metabolism. The NMRI showed
brain atrophy
and demyelinating defects. The PET scan showed cerebral blood flow and metabolic abnormalities that improved in one patient after neuropsychiatric recovery. These preliminary findings demonstrate cerebral derangements in patients with SLE cerebritis.
...
PMID:Cerebral involvement in systemic lupus erythematosus. 326 Jul 88
A 21-year-old female is described who developed severe cerebral
lupus
9 months after the onset of her disease. A dramatic change in her CT brain scan from normal to gross
cerebral atrophy
was observed in the month following onset of her cerebral disease. This patient developed hepatitis during the course of her hospitalization. This is an unusual manifestation of systemic
lupus
. The patient's serum also contained anti-Sm antibodies. This is a relatively infrequent finding in the serum of
lupus
patients outside the United States.
...
PMID:Rapid development of cerebral atrophy in systemic lupus erythematosus. 373 Jul 39
Three cases are presented, in two of which the CNS lesions revealed the presence of systemic lupus erythematosus (SLE). The diagnosis of SLE was certain according to the criteria of the ARA, and it was further confirmed by results of renal needle puncture biopsy. Case 1: A 16-year-old adolescent developed choreic movements followed, one month later, by psychotic symptoms suggesting a mixed hebephrenic-catatonic schizophrenic affection. Cutaneous lesions and signs of renal insufficiency 3 months later established that these disorders were related to SLE. A favourable outcome was observed rapidly for the systemic signs, recovery from neuropsychic symptoms being obtained after 3 months only but then in a few days. This course suggests the diagnosis of a "functional psychosis" of
lupus
origin. Case 2: A 24-year-old woman developed left hemiparesis followed by febrile coma. The slowly favourable course of the disease led to the appearance of a progressive dementia, with numerous epileptic seizures. Although tests for antinuclear antibodies were negative and the ESR was normal, several minor biological anomalies were suggestive of a systemic disease and the diagnosis of SLE was finally established. Corticotherapy produced only slight transient improvement. This progression towards dementia with progressive
cerebral atrophy
is most probably related to cerebral
lupus
lesions, the initial coma in the absence of any other apparent cause possibly being the first sign. Case 3: A 47-year-old woman developed simultaneously or separately episodes of arthralgia and uveitis of unknown origin over a 12-year period, and attacks of regressive multilocular neurological deficiency over a 15-year period.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[Central nervous system involvement in systemic lupus erythematosus]. 671 10
Thirty-two patients with systemic lupus erythematosus were evaluated clinically and with computed tomography in order to determine whether the occurrence of
cerebral atrophy
in systemic lupus erythematosus was due to the steroid therapy or the cerebral manifestations of the disease itself. Of these patients, 14 had central nervous system manifestations of the disease (
lupus
cerebritis) and 12 of the 14 were on long-term steroid therapy. Eighteen patients had no clinical evidence of
lupus
cerebritis and all were on long-term steroids. Of the 14
lupus
cerebritis patients, 10 showed moderate
cerebral atrophy
, four minimal atrophy, and none were normal. Of the 18 patients without
lupus
cerebritis, none had moderate atrophy, six (33%) showed minimal atrophy, and 12 (67%) had normal CT scans. This data suggest that it is the
lupus
cerebritis rather than the steroid therapy that is responsible for the moderate
cerebral atrophy
. In patients suspected of
lupus
cerebritis, steroids should not be withheld because of concern for steroid-induced atrophy. Rather, the dose may need to be increased.
...
PMID:Cerebral atrophy in systemic lupus erythematosus: steroid- or disease-induced phenomenon? 680 Feb 37
We investigated the relationship between antiphospholipid antibodies (APA) and regional cerebral blood flow (rCBF) on 25 patients with systemic lupus erythematosus (SLE).
Lupus
anticoagulant (LA) and anticardiolipin antibody-IgG (ACA-IgG) as a marker of APA were determined. Brain CT and single photon emission CT (SPECT) were performed to evaluate the rCBF. LA was positive in 8 cases (32%), and ACA-IgG was positive in 3 cases (12%), respectively. Brain CT revealed
brain atrophy
in 8 cases (32%), but none of them had localized lesions. SPECT disclosed a reduced rCBF in 11 cases (44%). A reduced rCBF was noted to have a significant relationship with LA (p < 0.005), but not with ACA-IgG. It was suggested that LA might be an important factor as the cause of rCBF disturbances detected by SPECT in SLE patients.
...
PMID:[Antiphospholipid antibodies and regional cerebral blood flow in systemic lupus erythematosus]. 831 2
A 76.2% prevalence of abnormalities was found in the cerebral MR scans of 21 patients with systemic lupus erythematosus (SLE). These patients were enrolled in the study consecutively as they presented at an immunological out-patient unit. They were not selected on the basis of neuro/psychiatric findings. Circumscribed non-periventricular brain lesions were found in 12 patients (57.1%), mainly in the frontal white or gray matter. Periventricular lesions directly adjacent to the ventricles were detected in 10 patients (47.6%). Eleven patients (52.4%) showed signs of
cerebral atrophy
. MRI detected more lesions in patients with clinically focal CNS
lupus
than in patients with seizures or patients without clinically localized findings. Eleven patients had abnormal neuropsychiatric CNS findings; there was no clear correlation between neuropsychiatric signs and symptoms and brain abnormalities as shown by MRI. Seven patients had asymptomatic lesions. Cerebral MRI proved to be the method of choice for the non-clinical diagnosis of neuropsychiatric SLE.
...
PMID:Systemic lupus erythematosus: neuropsychiatric signs and symptoms related to cerebral MRI findings. 845 12
Cerebral lupus (CL) is a common cause of morbidity and mortality in patients with SLE. The brain CTs of 27 consecutive adult patients with SLE and various neurological presentations were reviewed. The median age and duration of neurological symptoms at the time of the brain CT were 30 years (range = 14-51 years) and six days (range = 1 day-22 years), respectively. Eleven patients (41%) had normal CTs. The abnormalities in the remaining patients could be divided into six categories: (a)
cerebral atrophy
alone (two patients); (b) calcification alone (three patients); (c) infarct(s) alone (five patients); (d)
cerebral atrophy
and calcification (three patients); (e)
cerebral atrophy
and infarct(s) (one patient) and (f)
cerebral atrophy
, calcification and infarct(s) (two patients). Altogether eight patients (30%) (age range = 17-47 years) had intracerebral calcification: the globus pallidus was involved in all, putamen in two, head of the caudate nucleus in one, thalamus in one, centrum semiovale in two and cerebellum in three patients. Two patients had extensive calcifications of most of the basal ganglia, centrum semiovale and cerebellum. There was no relationship between the presence/degree of calcification and age of patients/duration or type of neurological presentation. The pathogenesis of cerebral calcification in CL is unknown. Cerebral lupus must now be included in the differential diagnosis of intracerebral calcification.
Lupus
1996 Apr
PMID:Brain calcification in patients with cerebral lupus. 874 25
The purpose of our study was to define the neuroimaging features of the cardiolipin antibody syndrome. Thirty-eight patients with elevated anticardiolipin antibody titers were studied with magnetic resonance imaging or computed tomography or both. Two patients underwent cerebral angiography. All patients had recurrent transient ischemic attacks, amaurosis, or strokes. One patient had normal imaging findings. The remaining patients had a combination of infarction and atrophy. Focal infarcts, the most common finding, were seen in 32 patients.
Cerebral atrophy
was seen in 26 patients and was the only radiographic finding in 5. Angiography demonstrated dramatic abnormalities in the distal portions of the anterior and posterior circulations, with multiple stenosis and occlusions and extensive pial and transdural collateral networks. The cardiolipin antibody syndrome should be suspected in young patients with transient ischemic attacks or strokes in the absence of the usual risk factors for cerebrovascular disease. The presence of raised anticardiolipin antibody titers or the cardiolipin antibody syndrome in patients with
lupus
, in those with other connective tissue diseases, and in patients without overt manifestations of an autoimmune disorder should be viewed as a risk factor for future ischemic cerebrovascular events. Further understanding of the precise role of these antibodies in the pathogenesis of vascular thrombosis may lead to a better understanding of the mechanisms underlying certain forms of stroke.
...
PMID:The neuroimaging features of the cardiolipin antibody syndrome. 911 34
A 37-year-old man sought medical advice because of an 8-year history of a slowly progressive dementing illness with no clinically apparent discrete strokelike episodes. Cognitive functioning was markedly, globally impaired without lateralizing or localizing features. Widespread livedo reticularis led to a diagnosis of Sneddon's syndrome. Antiphospholipid antibodies and
lupus
anticoagulant were negative. Magnetic resonance imaging showed widespread
cerebral atrophy
, cortical and subcortical cerebral infarcts, and extensive periventricular white matter abnormalities. Cerebral angiography revealed diffuse medium- and small-vessel occlusive disease, with numerous collaterals in the mid and distal circulation but no evidence of atherosclerosis or vasculitis. No other cause of a dementing illness was found. We postulate that our patient's dementia was due to the cumulative effects of multiple cerebral infarcts.
...
PMID:Gradually progressive dementia without discrete cerebrovascular events in a patient with Sneddon's syndrome. 1059 61
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