Microembolic signals in patients with systemic lupus erythematosus.
BACKGROUND
Central nervous system (CNS) involvement is a common and less understood aspect of systemic lupus erythematosus (SLE). Microembolic signals (MES) have been reported in SLE. We conducted a prospective study to evaluate the frequency of MES among patients with CNS involvement and those without. The main aim of the study is to clarify the pathophysiology of the CNS involvement in SLE.


METHODS
Sixty eight patients with a diagnosis of SLE (60 females, 8 males) participated in the study. Both middle cerebral arteries were monitored using transcranial Doppler for 60 min to detect MES. All cases underwent neurology and psychiatry assessments.


RESULTS
MES were detected in 7/68 patients (10.3%) with the mean number of 3.5 per hour. MES were significantly higher in patients with CNS involvement (6/24, 25%) than those without (1/44, 2.2%) (P=0.006). SLE disease activity index, duration of disease, plaque formation, intima-media thickness, and antiphospholipid antibodies were not associated with MES. MES were more frequent in patients receiving Aspirin and/or Warfarin (p=0.02).


CONCLUSIONS
MES may be a predictor for CNS involvement in SLE patients at risk for neuropsychiatric syndromes. Cerebral embolism may be implicated in the pathophysiology of neuropsychiatric SLE.
Azarpazhooh
Mahmoud Reza
MR
Department of Neurology, Ghaem Medical Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Mokhber
Naghmeh
N
Orouji
Elias
E
Chambers
Brian R
BR
Hatef
Mohammad Reza
MR
Rezaieyazdi
Zahra
Z
Sedighi
Sima
S
Foroghipoor
Mohsen
M
Velayati
Arash
A
Gharavi
Morteza Modares
MM
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000209:etiology*; D008180:Lupus Erythematosus, Systemic / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods; D055815:Young Adult