title: Neuropsychiatric lupus and association with cerebrospinal fluid immunoglobulins: a pilot study.
abstract: BACKGROUND
  Recent experimental evidence points to brain-reactive antibodies as a key factor in the pathogenesis of neuropsychiatric systemic lupus erythematosus (central nervous system-SLE). However, clinical studies in which circulating (serum) autoantibodies were correlated with neuropsychiatric manifestations have not produced consistent findings.
  
  
  OBJECTIVE
  To test the hypothesis that autoantibodies in cerebrospinal fluid are more reflective of functional brain damage.
  
  
  METHODS
  We compared the behavioral profiles of 12 NP-SLE patients, some of whom had immunoglobulin G in their CSF.
  
  
  RESULTS
  Western blotting revealed heavy and light chain IgG bands in six patients similar in age to the subgroup of CSF IgG-free patients. A series of serological measures did not differ between the subgroups, but SLEDAI scores and daily steroid doses were higher in patients with IgG in their CSF. All three patients with severe deficits in verbal and executive functions were positive for the CSF IgG, while three other patients with psychosis were CSF IgG-negative.
  
  
  CONCLUSIONS
  Although the present sample size is relatively small, the results support the relationship between disease severity and central manifestations of autoimmunity. They also emphasize the importance of clinical studies that compare subpopulations of NP-SLE patients and justify development of animal models in which controlled immune mechanisms induce specific deficits in behavior.
authors.affiliation: Department of Rheumatology, Bezanijska Kosa, University Medical Center, Belgrade.
authors.forename: Ljudmila
authors.initials: L
authors.lastname: Stojanovich
authors.forename: Dusica
authors.initials: D
authors.lastname: Smiljanich-Miljkovich
authors.forename: Roald
authors.initials: R
authors.lastname: Omdal
authors.forename: Boris
authors.initials: B
authors.lastname: Sakic
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000134:cerebrospinal fluid*; D001927:Brain Diseases / Q000209:etiology* / Q000276:immunology; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000209:etiology* / Q000276:immunology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid*; D020945:Lupus Vasculitis, Central Nervous System / Q000134:cerebrospinal fluid* / Q000150:complications / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010865:Pilot Projects; D011594:Psychometrics; D011618:Psychotic Disorders / Q000209:etiology* / Q000276:immunology
chemical_list: D001323:Autoantibodies; D007074:Immunoglobulin G
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