Recent observations on central nervous system lupus erythematosus.
The recent literature on CNS-SLE has been reviewed. An improved prognosis is noted that is thought to be due to the use of high-dose corticosteroids. The frequencies of the various neurologic and psychiatric findings are discussed, and a distinction is noted between organic psychoses and functional psychiatric complaints. The question of corticosteroids versus cerebral vasculitis as the cause of the neuropsychiatric symptomatology in SLE is examined, and the necessity of clear psychiatric diagnosis and treatment is stressed. Recent observations on HL-A antigens, complement, immunoglobulins, virus, and immunocomplexes suggest that the latter are prominent in CNS-SLE, but that an infectious agent may be etiologic in the genesis of SLE. Fifty-four patients not previously reported are discussed. Thirty-eight of them had neuropsychiatric manifestations. The treatment of CNS-SLE with cytotoxic agents, in addition to corticosteroids, is considered, and the experience of the authors with such treatment is presented.
D000818:Animals; D000914:Antibodies, Viral / Q000032:analysis; D001323:Autoantibodies / Q000032:analysis; D001379:Azathioprine / Q000627:therapeutic use; D002493:Central Nervous System Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D002648:Child; D003165:Complement System Proteins / Q000134:cerebrospinal fluid; D003520:Cyclophosphamide / Q000627:therapeutic use; D004285:Dogs; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use; D006680:HLA Antigens / Q000032:analysis; D006801:Humans; D007136:Immunoglobulins / Q000134:cerebrospinal fluid; D007165:Immunosuppression Therapy; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D008459:Measles virus / Q000472:pathogenicity; D001523:Mental Disorders / Q000209:etiology*; D051379:Mice; D009461:Neurologic Manifestations; D011241:Prednisone / Q000627:therapeutic use; D012640:Seizures / Q000209:etiology
D000914:Antibodies, Viral; D001323:Autoantibodies; D005938:Glucocorticoids; D006680:HLA Antigens; D007136:Immunoglobulins; D003520:Cyclophosphamide; D003165:Complement System Proteins; D001379:Azathioprine; D011241:Prednisone