Neuropsychiatric systemic lupus erythematosus detected using extravascular spillage signal on dynamic magnetic resonance imaging (Ktrans)

Rheumatology ◽  
2021 ◽  
Author(s):  
Yuya Fujita ◽  
Shigeru Iwata ◽  
Kazuhisa Nakano ◽  
Hiroaki Adachi ◽  
Yoshiya Tanaka
Keyword(s):  
Magnetic Resonance Imaging ◽  
Systemic Lupus Erythematosus ◽  
Magnetic Resonance ◽  
Lupus Erythematosus ◽  
Dynamic Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Systemic Lupus ◽  
Dynamic Magnetic Resonance ◽  
Neuropsychiatric Systemic Lupus Erythematosus

scholarly journals A critical analysis of the tools to evaluate neuropsychiatric lupus

Lupus ◽  
2017 ◽  
Vol 26 (5) ◽  
pp. 504-509 ◽  
Author(s):  
K E N Clark ◽  
C N Clark ◽  
A Rahman
Keyword(s):  
Magnetic Resonance Imaging ◽  
Systemic Lupus Erythematosus ◽  
Magnetic Resonance ◽  
Lupus Erythematosus ◽  
Neuropsychiatric Symptoms ◽  
Cognitive Testing ◽  
Resonance Imaging ◽  
Systemic Lupus ◽  
Neuropsychiatric Systemic Lupus Erythematosus ◽  
Neuropsychiatric Manifestations

Neuropsychiatric symptoms occur commonly in patients with systemic lupus erythematosus, but they are not always due to active disease. It is crucial to identify cases that are due to active systemic lupus erythematosus so that appropriate treatment can be instituted. There is no single serological or imaging test that distinguishes active neuropsychiatric systemic lupus erythematosus from neuropsychiatric manifestations caused by other factors such as infection. Most patients with neuropsychiatric systemic lupus erythematosus have generalised features of disease activity. Raised anti-dsDNA and low C3 complement levels are often seen, but are not an invariable guide. The presence of antiphospholipid antibodies is more suggestive of thrombotic than inflammatory causation. A number of other autoantibody tests have been proposed as biomarkers for neuropsychiatric systemic lupus erythematosus, but results in clinical studies have been inconsistent and none has so far entered routine clinical practice. Cerebrospinal fluid features and magnetic resonance imaging appearances are non-specific in neuropsychiatric systemic lupus erythematosus, but are useful in excluding other causes of neuropsychiatric symptoms. Newer magnetic resonance imaging sequences show promise for distinguishing new neuropsychiatric systemic lupus erythematosus activity from previous damage and recent research suggests these may correlate with changes in cognitive function in patients with systemic lupus erythematosus. However, formal cognitive testing is seldom carried out in the acute setting.

scholarly journals Comparison of structural magnetic resonance imaging findings between neuropsychiatric systemic lupus erythematosus and systemic lupus erythematosus patients: A systematic review and meta-analysis

2017 ◽  
Vol 2 ◽  
pp. 205990211666305 ◽  
Author(s):  
Omed Amin ◽  
Arvind Kaul ◽  
Toby O Smith ◽  
Franklyn A Howe ◽  
Nidhi Sofat
Keyword(s):  
Magnetic Resonance Imaging ◽  
Systemic Lupus Erythematosus ◽  
Magnetic Resonance ◽  
Confidence Interval ◽  
Risk Ratio ◽  
Lupus Erythematosus ◽  
Brain Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Systemic Lupus ◽  
Neuropsychiatric Systemic Lupus Erythematosus

Introduction: Neuropsychiatric systemic lupus erythematosus is often clinically challenging to diagnose, treat and monitor. Although brain magnetic resonance imaging is frequently performed before lumbar puncture in neuropsychiatric systemic lupus erythematosus, it is not clear from the literature whether specific brain magnetic resonance imaging findings are associated with distinct clinical features of neuropsychiatric systemic lupus erythematosus. Methods: We conducted a systematic review and meta-analysis on published studies of neuropsychiatric systemic lupus erythematosus including brain magnetic resonance imaging and the 1999 American College of Rheumatology-defined clinical neuropsychiatric systemic lupus erythematosus syndromes to determine their relationship. Pooled prevalence and risk ratio for distinct neuropsychiatric systemic lupus erythematosus associations were determined with 95% confidence intervals. Results: Of 821 studies screened, 21 fulfilled inclusion criteria. A total of 818 participants were evaluated (91% female) with 1064 neuropsychiatric systemic lupus erythematosus episodes assessed. Neuropsychiatric systemic lupus erythematosus features included headache (24%), seizures (19%), cerebrovascular disease (18%), cognitive dysfunction (15%) and acute confusional state (14%). Normal magnetic resonance imaging was significant for anxiety disorder (risk ratio: 9.00; 95% confidence interval: 2.40, 33.79), autonomic disorder (risk ratio: 7.00; 95% confidence interval: 0.51, 96.06) and plexopathy (risk ratio: 5.00; 95% confidence interval: 0.81, 31.00). Highest risk ratio of neuropsychiatric systemic lupus erythematosus syndrome with abnormal magnetic resonance imaging was observed for cerebrovascular disease (risk ratio: 0.15; 95% confidence interval: 0.10, 0.24) and demyelination (risk ratio: 0.11; 95% confidence interval: 0.02, 0.72). Conclusion: Normal magnetic resonance imaging in neuropsychiatric systemic lupus erythematosus was the most significant correlate from our meta-analysis for psychological symptoms including anxiety and peripheral nerve features of autonomic disorder and plexopathy. The main abnormal brain magnetic resonance imaging correlates included cerebrovascular disease and demyelination. Brain magnetic resonance imaging correlates poorly with neuropsychiatric systemic lupus erythematosus features, and specific clinical symptoms should be the main determinants of performing magnetic resonance imaging rather than presence of neuropsychiatric systemic lupus erythematosus per se.

Sign in / Sign up

Export Citation Format

Share Document