title: Pattern of MRI brain in neuro-psychiatric SLE. Effect of anti-phospholipid antibodies: A study at a tertiary care teaching hospital.
abstract: OBJECTIVE
  To compare the neuro-radiologic findings in Systemic lupus erythematosus (SLE) patients with and without antiphospholipid antibodies (aPL) in different neuro-psychiatric manifestations.
  
  
  METHODS
  This cross-sectional comparative study was carried out at King Khalid University Hospital, a tertiary care teaching hospital, Riyadh, Saudi Arabia from June 2012 to January 2015. Ninety seven SLE patients with neuro-psychiatric manifestations were included in the study and divided into two groups. Group I (50 patients) SLE with aPL and group II (47 patients) SLE without aPL. We compared Demographic features, clinical manifestations and magnetic resonance imaging (MRI) brain findings.
  
  
  RESULTS
  Demographic and clinical characteristics of two groups were similar. In Group-I, anticardiolipin antibodies (aCL) were most common (86%). In patients with headache, most of the patients in Group-I had white matter hyperintensities (WMHIs) (50% vs 27%) while most of the patients in Group-II had normal MRI brain (38% vs 73%). Similarly WMHIs were found more in Group-I patients with seizures (60% vs 21%), while ischemia/infarction, atrophy and normal MRI were found in Group-II. MRI brain in patients with neurological deficit and psychiatric disorder were not much different in both the groups.
  
  
  CONCLUSIONS
  We found no statistically significant differences in frequencies of MRI brain abnormalities in SLE patients with and without aPL antibodies. Each of the three aPL may have a variable effect on the brain.
authors.affiliation: Khalid Parvez, FCPS, MRCP. Registrar, Division of Rheumatology, Department of Medicine, King Khalid University Hospital (KKUH), King Saud University (KSU), Riyadh, Saudi Arabia.
authors.forename: Khalid
authors.initials: K
authors.lastname: Parvez
authors.affiliation: Abdul Rahman Saud Al-Arfaj, MRCP, FRCPC, ABIM, Professor of Rheumatology, Department of Medicine, King Khalid University Hospital (KKUH), King Saud University (KSU), Riyadh, Saudi Arabia.
authors.forename: Abdul Rahman Saud
authors.initials: AR
authors.lastname: Al-Arfaj
authors.affiliation: Muhammad Afzal Hamdani, FCPS, Dip-Card., MRCP. Senior Registrar, Division of Rheumatology, Department of Medicine, King Khalid University Hospital (KKUH), King Saud University (KSU), Riyadh, Saudi Arabia.
authors.forename: Muhammad Afzal
authors.initials: MA
authors.lastname: Hamdani
authors.affiliation: Faisal Naseeb, FCPS, MRCP. Registrar, Division of Rheumatology, Department of Medicine, King Khalid University Hospital (KKUH), King Saud University (KSU), Riyadh, Saudi Arabia.
authors.forename: Faisal
authors.initials: F
authors.lastname: Naseeb
authors.affiliation: Dr. Abdulkader Daif, MD. Professor of Neurology, Department of Medicine, King Khalid University Hospital (KKUH), King Saud University (KSU), Riyadh, Saudi Arabia.
authors.forename: Abdulkader
authors.initials: A
authors.lastname: Daif
authors.affiliation: Sajjad Hussain MD. Assistant Professor and Consultant Neuro-radiologist, Department of Radiology, King Khalid University Hospital (KKUH), King Saud University (KSU), Riyadh, Saudi Arabia.
authors.forename: Sajjad
authors.initials: S
authors.lastname: Hussain
keywords: Antiphospholipid antibodies; Lupus anticoagulant; Magnetic resonance imaging; Systemic lupus erythematosus; White matter hyperintensities; venous sinus thrombosis