Central nervous system lupus erythematosus: measurement of cerebrospinal fluid cyclic GMP and other clinical markers of disease activity.
Cyclic-GMP (C-GMP), a normal constituent of the central nervous system, was found to be present in increased amounts in the cerebrospinal fluid (CSF) of systemic lupus erythematosus (SLE) patients with active neurologic disease. Twenty-four CSF samples from 17 patients with SLE were evaluated for C-GMP concentration by radioimmunoassay. This study extends our initial observations and examines three groups of SLE patients based on their clinical status at the time of each lumbar puncture: those with active neurologic and psychologic abnormalities (group I), active neurologic abnormalities (group II), and psychologic abnormalities without active neurologic involvement (group III). Groups I and II had mean CSF C-GMP values of 3.1 nM +/- 0.64 (SE) and 4.1 nM +/- 0.10 respectively, which were both significantly higher than the mean for group III (1.2 nM +/- 0.43) (P less than 0.05). Other CSF findings did not display this close correlation with activity of neurologic disease. In 4 SLE patients, significantly higher levels of CSF C-GMP were found on serial sampling during times when neurologic abnormalities were active. Thus elevated CSF C-GMP concentration may be a marker of active neurologic disease in SLE.
D000328:Adult; D001799:Blood Sedimentation; D002493:Central Nervous System Diseases / Q000097:blood / Q000134:cerebrospinal fluid* / Q000188:drug therapy; D002555:Cerebrospinal Fluid / Q000166:cytology; D003165:Complement System Proteins / Q000032:analysis; D006152:Cyclic GMP / Q000134:cerebrospinal fluid*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007958:Leukocyte Count; D007970:Leukopenia / Q000209:etiology; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000134:cerebrospinal fluid* / Q000188:drug therapy; D008297:Male; D019965:Neurocognitive Disorders / Q000209:etiology; D009461:Neurologic Manifestations; D011241:Prednisone / Q000627:therapeutic use; D011619:Psychotropic Drugs / Q000627:therapeutic use; D011863:Radioimmunoassay; D013129:Spinal Puncture; D013921:Thrombocytopenia / Q000209:etiology
D006454:Hemoglobins; D011619:Psychotropic Drugs; D003165:Complement System Proteins; D006152:Cyclic GMP; D011241:Prednisone