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Intrathecal immunoglobulin production in patients with systemic lupus erythematosus with neuropsychiatric manifestations
  1. Mo Yin Mok1,
  2. Eric Y T Chan2,
  3. Woon Sing Wong1,
  4. Chak Sing Lau1
  1. 1Department of Medicine, Queen Mary Hospital, Hong Kong
  2. 2Department of Pathology, Queen Mary Hospital, Hong Kong
  1. Correspondence to:
    Dr M Y Mok
    Department of Medicine, Queen Mary Hospital, Pokfulam Road, Hong Kong; mymok{at}netvigator.com

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Neuropsychiatric manifestations have been reported in 30–60% of patients with systemic lupus erythematosus (SLE), with variable IgG synthesis in cerebrospinal fluid (CSF).1 In this study, we sought to examine intrathecal IgG synthesis measured qualitatively as the IgG index,2 calculated using the formula

(IgG CSF/IgG serum)/(albumin CSF/albumin serum),

and quantitatively as oligoclonal bands (OCBs) by isoelectric focusing (IEF)3 in patients with SLE with various neurological presentations, and to determine the cut-off of the IgG index for the detection of these pathological IgG.

CSF results were retrieved from a database of 2902 samples using the keywords “SLE” or “lupus”. Only the first CSF sample taken before treatment for each neurological episode in each patient was analysed. Samples from …

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