Robert Terkeltaub, MD


February 01, 2001


Could you describe recent advances in the treatment of lupus cerebritis?

Ahmed El-Rafie, MBBCh, MSc, MRCP

Response from Robert Terkeltaub, MD

Application of any advances in the treatment of lupus cerebritis still hinges on proper diagnosis of the condition, and there is still no single specific laboratory test for it. Two newer diagnostic imaging modalities, positron electron tomography and single photon emission computed tomographic scanning, are under investigation for central nervous system (CNS) lupus, but they have limitations that have precluded their widespread applicability in clinical diagnosis for this disease.[1] The mainstays of management remain steroids and, for refractory disease, pulse cyclophosphamide. However, preliminary reports suggest the possibility that in some refractory cases there could be a therapeutic niche for newer approaches such as use of mycophenolate mofetil, a trial of intravenous immunoglobulin gamma, or bone marrow ablation with autologous stem cell replacement.[2,3,4,5]


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