TRANSCRANIAL DOPPLER MAY REVEAL ASYMPTOMATIC CEREBRAL VASCULOPATHY INSYSTEMIC LUPUS-ERYTHEMATOSUS

The central nervous system is clinically affected in about half of the systemic lupus erythematosus (SLE) patients. Mean blood flow velociti es in the middle cerebral artery measured by transcranial Doppler ultr asound (TCD), before acetazolamide administration, were significantly higher in 9 patients without neurological symptoms and without MRI abn ormalities (74.5 +/- 3.1 cm/s; mean +/- SEM) than in 10 healthy contro ls (56 +/- 2.8 cm/s) or in hemispheres of 6 SLE patients with neurolog ical symptoms (44.5 +/- 2.6 cm/s). After acetazolamide, the response w as significantly higher in symptom-free SLE patients (125 +/- 4.6 cm/s ) and lower in 6 patients with focal neurological symptoms in the affe cted hemisphere (66.5 +/- 3.1 cm/s) compared with healthy controls (87 .3 +/- 4.1 cm/s). Our results suggest that the severity of impairment of the cerebral vessels is detectable by TCD in SLE patients. The acet azolamide test is suggested to be used in the follow-up of this diseas e.