title: Intrathecal injection with methotrexate plus dexamethasone in the treatment of central nervous system involvement in systemic lupus erythematosus.
abstract: OBJECTIVE
  To investigate the effect of intrathecal injection (i.t.) with methotrexate (MTX) plus dexamethasone (DXM) in treating central nervous system involvement in systemic lupus erythematosus (CNS lupus).
  
  
  METHODS
  Twenty-four CNS lupus patients that were refractory to conventional steroid therapy were selected for i.t. with MTX 10-20 mg plus DXM 10-20 mg. The effects and side effects of i.t. were closely observed.
  
  
  RESULTS
  The symptoms and signs of 22/24 (91.7%) CNS lupus patients receiving i.t. improved considerably. Cerebrospinal fluid pressure, protein and WBC levels declined from 201.5 +/- 155.4 mm H2O, 145.2 +/- 87.6 mg/dl and 25.1 +/- 14.3/mm3 to 128.7 +/- 108.1 mm H2O, 60.8 +/- 38.3 mg/dl and 6.8 +/- 2.1/mm3 respectively. Transient side effects were observed in 4 patients: 1 with itching sensation of lower limbs, 2 with headache and 1 with incontinence.
  
  
  CONCLUSIONS
  I.t. with MTX plus DXM is a promising method for treating CNS lupus and deserves further investigation.
authors.affiliation: Department of Rheumatology, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, East City, Beijing 100730, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Dong
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.forename: F
authors.initials: F
authors.lastname: Tang
authors.forename: X
authors.initials: X
authors.lastname: Tian
authors.forename: Y
authors.initials: Y
authors.lastname: Zhao
authors.forename: F
authors.initials: F
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D001927:Brain Diseases / Q000188:drug therapy*; D002648:Child; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged
chemical_list: D003907:Dexamethasone; D008727:Methotrexate