Usefulness of Tc-99m Ecd Brain Spect to Evaluate the Effects of Methylprednisolone Pulse Therapy in Lupus Erythematosus with Brain Involvement: A Preliminary Report
Resource
RHEUMATOLOGY INTERNATIONAL v.23 n.4 pp.182-185
Journal
RHEUMATOLOGY INTERNATIONAL
Journal Volume
v.23
Journal Issue
n.4
Pages
182-185
Date Issued
2003
Date
2003
Author(s)
Liu, F. Y.
Huang, W. S.
Kao, C. H.
Yen, R. F.
Wang, J. J.
Ho, S. T.
Abstract
Methylprednisolone pulse therapy (MPT) was introduced to avoid life- threatening complications in systemic lupus erythematosus (SLE) with brain manifestations. However, its efficacy in SLE patients remains uncertain and needs to be objectively evaluated. In this study, technetium-99m ethyl cysteinate dimer (Tc-99m ECD) brain single photon emission computed tomography (SPECT) was used to detect regional cerebral blood flow (rCBF) in SLE patients with normal brain magnetic resonance imaging (MRI) findings. Twelve female SLE patients with neuropsychiatric symptoms were enrolled in this study. All patients had normal brain MRI and abnormal Tc- 99m ECD brain SPECT findings. The Tc-99m ECD brain SPECT studies were performed 2 weeks after MPT. Pre- and post-MPT serum levels of anticardiolipin antibodies (ACA) and antiribosomal P antibodies (anti-P) were also measured. Before MPT, four patients had positive ACA and seven had positive anti-P. After MPT, all 12 patients demonstrated negative serologic findings and no neuropsychiatric symptoms . After MPT, ten patients showed complete recovery and two showed partial recovery of rCBF in the follow-up Tc-99m ECD brain SPECT images. This imaging is a logical and objective tool for measuring the effects of MPT in SLE patients with brain involvement by the determination of rCBF changes.
Subjects
methylpredisolone pulse therapy
systemic lupus erythematosus
Tc-99m ECD brain SPECT