Cerebral microembolism, a disease marker for ischemic cerebrovascular events in the antiphospholipid syndrome of systemic lupus erythematosus?
OBJECTIVE
We investigated whether the detectability of microembolic Doppler signals (MES) in the intracranial circulation may help to define the individual cerebrovascular risk in systemic lupus erythematosus (SLE) with antiphospholipid syndrome (APS).


METHODS
Retrospective cross-sectional study of 70 patients with SLE with or without APS, and 30 controls with a history of cerebral ischemia of unknown cause. Of all patients, 38 had a clinical history of APS and 32 did not.


RESULTS
15 patients with APS (39%) showed MES. In contrast, all patients without APS and 29 of 30 controls were microemboli-negative. MES were more strongly associated with cerebrovascular symptoms than with APS, antiphospholipid antibodies, or cardiac pathology. The time elapsed since the last ischemic cerebrovascular symptom was significantly shorter in microemboli-positive patients than in microemboli-negative patients (P<0.001).


CONCLUSIONS
MES may be related to disease activity in patients with SLE and APS. Their detection may help to assess individual cerebrovascular risk and contribute to therapeutic decision making and therapeutic monitoring.
Rademacher
J
J
Department of Neurology, Heinrich-Heine-University Düsseldorf, Germany.
Söhngen
D
D
Specker
C
C
Janda
I
I
Sitzer
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology / Q000276:immunology; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000276:immunology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D017585:Ultrasonography, Doppler, Transcranial