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MODERN RHEUMATOLOGY Vol.13 No.3
>MR13-3
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Tumor necrosis factor-alpha and neuropsychiatric lupus erythematosus: relation to single photon emission computed tomography findings
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| Bassel K. El-Zorkany1, Geilan A. Mahmoud1, Hesham A. Shahin2, Hosna Moustafa3 and Amira A. Shahin1 |
(1) Department of Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University, Cairo, Egypt
(2) Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
(3) Department of Nuclear Medicine and Radiation Oncology, Faculty of Medicine, Cairo University, Cairo, Egypt |
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| Received: 17 May 2002 Accepted: 17 December 2002 |
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Full Text
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| Abstract |
| This study was designed to highlight the relation of tumor necrosis factor- (TNF-) to neuropsychiatric lupus (NPLE) manifestations. The relation of TNF- to the type of single photon emission computed tomography (SPECT) findings in this context was also studied. Twenty-one systemic lupus erythematosus (SLE) females, mean age 27.57 ± 9.89 years, and twenty age-matched normal females (controls), were subjected to TNF- assessment. Different clinical and neuropsychiatric manifestations were evaluated. SPECT was carried out for all patients. The results showed that the mean TNF- level (pg/ml) was significantly raised in patients compared with controls (167.8 ± 102.5 versus 64 ± 50.2, respectively, P 0.005). Thirteen patients (69.1%) had NPLE manifestations. NPLE patients had a significantly higher mean TNF- than patients without NPLE (203 ± 102.8 versus 109 ± 47.3, respectively, P 0.03). Positive SPECT findings were found in 18 lupus patients (85.7%), including all 13 patients with NPLE (100% sensitivity), with a multiple focal pattern of hypoperfusion being the most frequent type (9/13), followed by diffuse (3/13), and then single focal pattern (1/13). The mean TNF- was significantly higher in patients with multiple focal pattern (P 0.001). In conclusion, results of this work support the hypothesis that TNF- could be involved in the pathogenesis of NPLE, and hence, it could be speculated that the evolving anti-TNF therapy can play a potential role in the management of this disease. |
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| Key words |
| Neuropsychiatric lupus erythematosus (NPLE) - Neuropsychiatry - Systemic lupus erythematosus (SLE) - Single photon emission computed tomography (SPECT) - Tumor necrosis factor- (TNF-) |
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