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MR Vol.13 No.3 indexに戻る
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MODERN RHEUMATOLOGY
Vol.13 No.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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| 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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