Cognitive Dysfunction in Neuropsychiatric Systemic Lupus Erythematosus

Melanie J. Harrison, MD, MS, Lisa D. Ravdin, PhD

Disclosures

Curr Opin Rheumatol. 2002;14(5) 

In This Article

Antiphospholipid Antibodies and Cognitive Dysfunction

Although several studies have implicated antiphospholipid antibodies as a significant risk factor for the development of cognitive dysfunction, this has been as a serum marker and potential precipitator of vascular injury (ie, formation of thrombi).[7,24,25] Lai et al., [26*] compared levels of IgG anticardiolipin antibodies in serum to that detected in cerebrospinal fluid (CSF) of SLE subjects with and without neuropsychiatric conditions, and two control populations. IgG levels were elevated among 11 of 18 CNS lupus subjects, including three with cognitive dysfunction. The IgG index, calculated as [IgGCSF/IgGserum]/[albuminCSF/albuminserum], was significantly higher among CNS lupus patients with elevated levels of IgG compared with controls. This suggests intrathecal synthesis of anticardiolipin antibodies as opposed to diffusion from the systemic circulation. Thus, the presence of anticardiolipin antibodies in the CSF may be injurious to neurologic tissue through immune mechanisms (ie, non-vascular).

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