الفهرس | Only 14 pages are availabe for public view |
Abstract Central nervous system affection in SLE patients is one of the most common complications and causes of death in lupus patients (Ko1•acs et a/., 1995). Much evidence indicates that control of immune response and. consequently the autoimmune disease is not· confined solely to the Immune system. In deed, a system of bidierctional communication between the immune and neuroendocrinal systems exists (Besedovsky et a/., 1995). The intrathecal synthesis of IL-6 in patients with SLE with CNS involvement, which is a potent stimulator of PRL secretion, suggests a role for PRL in pathogenesis of CNS manifestation of SLE (Jara et al., 1993). Several mechanisms including immune mediated vasculopathy and neuron reactive autoantibodies (How eta/., 1985) have been implicated in pathogenesis of CNS involvement. There is no single test to date that serves as the gold standard for diagnosis of NPSLE (Hirrohata eta/., 1985). SPECT is a measure of brain perfusion SPECT is non-invasive enables anatomic imaging of lesion and most important is mean of functional imaging. Alteral perfusion reflect abnormal function, therefore we can get information regarding reversibility of a lesion by objectively documenting improvement in perfusion (Julie et al., 1995). Aim of the work was to: 1- Predict CNS affection in SLE patients using SPECT. 2- To study the previous parameter as prognostic tool for CNS affection in SLE patients. 3- To study role ofPRL in CNS affection and disease activity. 4- To study role of anti-P-antibodies in pathogenesis of CNS affection in SLE patients. Thirty SLE patients and 10 control were included m this study, SLE patients were categorized into 3 groups: group I with Major NPSLE (n = 7). group II with Minor NPSLE (n = 3). group III with No NPSLE (n = 20). • We found abnormal SPECT scan in (83%) of group I and (33%) of group II, we found normal SPECT scan in (72%) of group III and (I 00%) of the control group. • We measured serum level of PRL hormone, we· found significant elevation of serum level of PRL in SLE patients versus control group, highly significant correlation between, serum PRL and CNS manifestation and disease activity score in SLE patients. • We measured anti-P-antibodies in SLE patients. There was a highly significant difference in SLE patients versus control group; we found no significant association between anti-P-antibodies and CNS manifestations although high prevalence anti-P-antibodies were in patients with CNS manifestation. Conclusion: Our results confirm that SPECT imaging is a sensitive tool for diagnosis of CNS involvement’s in SLE patients, while the meaning in perfusion deficits in patients without neuropsychiatric symptoms remains to be clarified, the domain of SPECT as a diagnostic tool may lie in the early detection of brain perli.1sion defects such as headache and cognitive disorders. • Prolactin hormone may serve as marker for active CNS lupus and disease activity. • Anti-P-antibodies may serve as a good marker for diagnosis of SLE. |