title: Usefulness of Tc-99m ECD brain SPECT to evaluate the effects of methylprednisolone pulse therapy in lupus erythematosus with brain involvement: a preliminary report.
abstract: Methylprednisolone pulse therapy (MPT) was introduced to avoid life-threatening complications in systemic lupus erythematosus (SLE) with brain manifestations. However, its efficacy in SLE patients remains uncertain and needs to be objectively evaluated. In this study, technetium-99m ethyl cysteinate dimer (Tc-99m ECD) brain single photon emission computed tomography (SPECT) was used to detect regional cerebral blood flow (rCBF) in SLE patients with normal brain magnetic resonance imaging (MRI) findings. Twelve female SLE patients with neuropsychiatric symptoms were enrolled in this study. All patients had normal brain MRI and abnormal Tc-99m ECD brain SPECT findings. The Tc-99m ECD brain SPECT studies were performed 2 weeks after MPT. Pre- and post-MPT serum levels of anticardiolipin antibodies (ACA) and antiribosomal P antibodies (anti-P) were also measured. Before MPT, four patients had positive ACA and seven had positive anti-P. After MPT, all 12 patients demonstrated negative serologic findings and no neuropsychiatric symptoms. After MPT, ten patients showed complete recovery and two showed partial recovery of rCBF in the follow-up Tc-99m ECD brain SPECT images. This imaging is a logical and objective tool for measuring the effects of MPT in SLE patients with brain involvement by the determination of rCBF changes.
authors.affiliation: Department of Nuclear Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: F Y
authors.initials: FY
authors.lastname: Liu
authors.forename: W S
authors.initials: WS
authors.lastname: Huang
authors.forename: C H
authors.initials: CH
authors.lastname: Kao
authors.forename: R F
authors.initials: RF
authors.lastname: Yen
authors.forename: J J
authors.initials: JJ
authors.lastname: Wang
authors.forename: S T
authors.initials: ST
authors.lastname: Ho
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D017153:Antibodies, Anticardiolipin / Q000097:blood; D001323:Autoantibodies / Q000097:blood; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000276:immunology; D002560:Cerebrovascular Circulation / Q000276:immunology*; D003545:Cysteine / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D020945:Lupus Vasculitis, Central Nervous System / Q000188:drug therapy*; D008775:Methylprednisolone / Q000008:administration & dosage*; D015609:Organotechnetium Compounds; D015800:Protozoan Proteins; D020551:Pulse Therapy, Drug; D019275:Radiopharmaceuticals; D012269:Ribosomal Proteins / Q000276:immunology; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D000893:Anti-Inflammatory Agents; D017153:Antibodies, Anticardiolipin; D001323:Autoantibodies; C064601:L12E protein, Trypanosoma cruzi; D015609:Organotechnetium Compounds; D015800:Protozoan Proteins; D019275:Radiopharmaceuticals; D012269:Ribosomal Proteins; C059659:technetium Tc 99m bicisate; D003545:Cysteine; D008775:Methylprednisolone