Usefulness of Tc-99m ECD brain SPECT to evaluate the effects of methylprednisolone pulse therapy in lupus erythematosus with brain involvement: A preliminary report
Journal
Rheumatology International
Journal Volume
23
Journal Issue
4
Pages
182-185
Date Issued
2003
Author(s)
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. Ihe 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.
SDGs
Other Subjects
autoantibody; cardiolipin antibody; cysteine ethyl ester tc 99m; methylprednisolone; prednisolone; ribosome p antibody; unclassified drug; adult; article; brain blood flow; brain disease; cerebellar ataxia; clinical article; confusion; controlled study; depression; drug efficacy; drug pulse therapy; female; follow up; human; nuclear magnetic resonance imaging; priority journal; psychosis; seizure; serology; single photon emission computer tomography; systemic lupus erythematosus; Adult; Anti-Inflammatory Agents; Antibodies, Anticardiolipin; Autoantibodies; Brain; Cerebrovascular Circulation; Cysteine; Female; Humans; Lupus Vasculitis, Central Nervous System; Methylprednisolone; Organotechnetium Compounds; Protozoan Proteins; Pulse Therapy, Drug; Radiopharmaceuticals; Ribosomal Proteins; Tomography, Emission-Computed, Single-Photon
Type
journal article