COTWIN CONTROL STUDY ON CEREBRAL MANIFESTATIONS OF SYSTEMIC LUPUS-ERYTHEMATOSUS

All available twin pairs with systemic lupus erythematosus (SLE) deriv ed from the Finnish Twin Cohort were studied by clinical evaluation, m agnetic resonance imaging (MRI), anticardiolipin (aCL), and antineurof ilament (ANFA) antibodies. One of the five monozygotic and one of the eight dizygotic pairs were concordant for SLE. 10 of the 15 patients s howed clinical neurological abnormalities, and 11 had abnormal MRI of the brain. Altogether, 12 patients were considered to have neuropsychi atric lupus (NPSLE). Seven of the 11 patients with long-term corticost eroid treatment had either central or cortical atrophy. High or modera te aCL level was found in eight patients and two co-twins. Of them, si x patients had at least two manifestations of the antiphospholipid syn drome. ANFAs were found in five patients and four co-twins. Five co-tw ins fulfilled some of the SLE criteria. Of them, three MZ twins and on e additional DZ co-twin with no ARA criteria had findings suggesting c entral nervous system (CNS) involvement. The results indicate that the majority of SLE patients has cerebral abnormalities either as a resul t of SLE, or concomitant risk factors. The co-twins without clinical S LE often have minor signs of SLE, and even they may have neurological and MRI abnormalities. However, their aCL and ANFA levels seem not to correlate with MRI abnormalities.