Background Hypoperfusion observed in cerebral SPECT studies of patients with SLE has been found to be related with clinical activity in 10 patients with SLE and no neuropsychiatric manifestations.1
Objectives To study the clinical significance of cerebral SPECT in unselected patients with SLE.
Methods We performed cerebral SPECT in 57 women with SLE seen consecutively in our clinic. In the same week that SPECT was performed, SLEDAI, ESR, the concentrations of anti-DNA antibody and the C3 and C4 complement fractions, and the SLICC/ACR tissue damage index were determined.
Results The mean age of patients was 37 years (SD 13.1) and the mean duration of the disease was 9.7 years (SD 6.3). Cerebral SPECT revealed hypoperfusion in 49 patients (86%), which was diffuse in 33 (57.9%) and patchy in 16 (28.1%). The most frequent sites of hypoperfusion were the frontal, temporal, and parietal cortical areas. Normal perfusion or mild hypoperfusion (unappreciable) was observed in 22 patients (38.6%) and moderate or intense hypoperfusion (appreciable) was observed in 27 (47.4%). Appreciable hypoperfusion was unrelated to age, duration of SLE, or the concentrations of anti-DNA antibodies and the C3 and C4 fractions. Patients with appreciable cerebral hypoperfusion had a more active clinical disease (mean SLEDAI 13.92; SD 8.44 vs 4.56; SD 4.15) (Mann-Whitney p < 0.005), more cumulative tissue damage (mean SLICC 2.66; SD 2.84 vs 1.03; SD 1.51) (p: 0.035), and higher ESR (mean 28.7; SD 22.5 vs 17.7; SD 13.3) (p: 0.023) than patients with a normal SPECT. Cerebral hypoperfusion was related with neuropsychiatric manifestations present at the time of study (17 of 27; 63% vs 3 of 30; 10%) (OR: 15.3) or cumulative (19 of 27; 70.4% vs 8 of 30; 26.7%) (OR: 6.5), whether mild (OR: 5.5) or severe (OR: 8.2).
Conclusion Cerebral hypoperfusion detected by SPECT was related with concomitant and previous neuropsychiatric manifestations, the clinical activity of SLE, and cumulative tissue damage.
Rev Esp Reumatol. 2000;27:202
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