Background Clinical manifestations of neurologic involvement in patients with SLE (Neuropsychiatric SLE or NPSLE) may be either due to secundary causes such as antiphospholipid-syndrome associated infarctions or bleedings or infections, or due to primary causes such as immune-mediated vasculitis or cerebritis. Depending on the probable cause, different therapeutic approaches are chosen.
Objectives Previous reports on histopathologic have suggested that, since it is so seldomly found, cerebral vasculitis cannot be an important cause of neurologic symptoms in SLE.
Results However, a search in the computer archives of PALGA, the foundation that collects all pathology reports from Dutch PA-laboratories, beginning in 1988 and covering all reports since 1990, revealed vasculitis laesions in no less than 5 of 24 cranial autopsies of patients with SLE. In an additional 4, laesions were described that were compatible with remnants of previous vasculitis.
Conclusion These findings suggest that cerebral vasculitis must be considered as a possible underlying cause of symptoms when it comes to choosing therapy for patients with NPSLE.
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