RESEARCH - Brain MRI in newly diagnosed SLE

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J Rheumatol. 2008 Sep 15.

Brain Magnetic Resonance Imaging in Newly Diagnosed Systemic Lupus

Erythematosus.

Petri M, Naqibuddin M, Carson KA, Wallace DJ, Weisman MH, Holliday SL,

Sampedro M, Narayana S, Fox PT, lin C, Padilla PA, Brey RL.

From the s Hopkins University, Baltimore, land; Cedars-Sinai

Medical Center/ Geffen School of Medicine at UCLA, Los Angeles,

California; South Texas Veterans Health Care System, San ,

Texas; and University of Texas Health Science Center at San ,

San , Texas, USA.

OBJECTIVE: We wished to determine the prevalence of cerebral atrophy

and focal lesions in a cohort of patients with newly diagnosed

systemic lupus erythematosus (SLE) and the association of these brain

abnormalities with clinical characteristics.

METHODS: A total of 97 patients with SLE, within 9 months of

diagnosis, with 4 or more American College of Rheumatology

classification criteria, were enrolled. Brain magnetic resonance

imaging was performed.

RESULTS: The patients were 97% female, mean age 38.1 (SD 12.2) years,

education 15.1 (2.8) years; 59 Caucasian, 11 African American, 19

Hispanic, 5 Asian, and 3 other ethnicity. Cerebral atrophy was

prevalent in 18% (95% CI 11%-27%): mild in 12%, moderate in 5%. Focal

lesions were prevalent in 8% (95% CI 4%-16%): mild in 2%, moderate in

5%, severe in 1%. Patients with cerebral atrophy were more likely to

have anxiety disorder (p = 0.04). Patients with focal lesions were

more likely to be African American (p = 0.045) and had higher Safety

of Estrogens in Lupus Erythematosus National Assessment SLEDAI scores

(p = 0.02) and anti-dsDNA (p = 0.05).

CONCLUSION: In this population with newly diagnosed SLE, brain

abnormalities were prevalent in 25% of patients. These findings

suggest that the brain may be affected extremely early in the course

of SLE, even before the clinical diagnosis of SLE is made. Followup of

these patients is planned, to determine the reversibility or

progression of these abnormalities and their association with and

potential predictive value for subsequent neuropsychiatric SLE

manifestations.

PMID: 18793003

http://www.ncbi.nlm.nih.gov/pubmed/18793003

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