title: Autoantibodies in neuropsychiatric lupus.
abstract: The American College of Rheumatology presented a consensus document in 1999 proposing the classification of 19 different syndromes defined by neurological and psychiatric manifestations of systemic lupus erythematosus (SLE). The detection of autoantibodies in patient's serum or cerebrospinal fluid has not been used as diagnostic markers for the proposed neuropsychiatric lupus classifications as their disease associations remain highly contentious. Autoantibodies detected in the serum and/or cerebrospinal fluid, that have been reported to segregate with patients presenting with neuropsychiatric lupus include: (1) anti-neuronal antibodies, (2) brain-lymphocyte cross-reactive antibodies, (3) anti-ribosomal P antibodies, (4) anti-phospholipid antibodies and (5) anti-ganglioside antibodies. Tests for anti-neuronal, anti-brain-lymphocyte cross-reactive and anti-ganglioside antibodies remain highly specialized whereas tests for ribosomal P antibodies and for antiphospholipid antibodies are currently routinely available in most diagnostic laboratories. Anti-ribosomal antibodies segregate with SLE. Antiphospholipid P antibodies are markers for the antiphospholipid syndrome. This syndrome may be associated with another disease, commonly SLE. In this setting, neuropsychiatric manifestations in SLE may arise as a consequence of thrombotic episodes involving the cerebral vasculature. There is a pressing need for antibodies to ribosomal P and to phospholipids to be standardized for routine diagnostic application. We conclude that the search for specific antibody marker(s) that can be applied for the routine laboratory diagnosis for neuropsychiatric lupus remains elusive.
authors.affiliation: Department of Pathology and Immunology, Monash University Medical School, Prahran, Vic., Australia.
authors.forename: Deanne L V
authors.initials: DL
authors.lastname: Greenwood
authors.forename: Veronika M
authors.initials: VM
authors.lastname: Gitlits
authors.forename: Frank
authors.initials: F
authors.lastname: Alderuccio
authors.forename: John W
authors.initials: JW
authors.lastname: Sentry
authors.forename: Ban-Hock
authors.initials: BH
authors.lastname: Toh
mesh_terms: D017152:Antibodies, Antiphospholipid / Q000276:immunology; D001323:Autoantibodies / Q000276:immunology*; D001921:Brain / Q000276:immunology / Q000473:pathology; D005732:Gangliosides / Q000276:immunology; D006801:Humans; D020945:Lupus Vasculitis, Central Nervous System / Q000097:blood / Q000276:immunology* / Q000473:pathology; D012269:Ribosomal Proteins / Q000276:immunology
chemical_list: D017152:Antibodies, Antiphospholipid; D001323:Autoantibodies; D005732:Gangliosides; D012269:Ribosomal Proteins