ALTERATIONS OF CEREBRAL BLOOD-FLOW AND ANTIPHOSPHOLIPID ANTIBODIES INPATIENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS

Twenty-two patients with systemic lupus erythematosus and 13 healthy c ontrols were included in a cerebral blood flow study and underwent bra in-dedicated single-photon emission computed tomography using (99m)tec hnetium-d, 1-hexamethylpropylene amine oxime together with a brain com puted tomography scan. Plasma levels of antiphospholipid antibodies (l upus anticoagulant and anticardiolipin IgM and IgG antibodies) were al so determined. Brain computed tomography showed signs of focal cerebra l ischemia in 4 patients (18%), whereas cerebral blood flow by single- photon emission computed tomography was abnormal in 13 of 22 patients (59%), who showed bilateral or monolateral hypoperfusion in the tempor o-parietal regions. Patients with abnormal cerebral blood flow had a l onger duration of disease than those with normal blood flow (8.9+/-1.9 years vs. 5.3+/-1.5 years, P<0.05). Plasma antiphospholipid antibodie s were present in 15 patients (68%), but the prevalence was similar in those with normal (6/9,66%), or abnormal (9/13, 69%) cerebral blood f low. No statistically significant difference in lupus anticoagulant or anticardiolipin antibodies was observed between patients with and wit hout cerebral blood flow abnormalities. Our study shows that patients with systemic lupus erythematosus frequently have cerebral blood flow abnormalities, which could precede those observed by computed tomograp hy. Plasma lupus anticoagulant and anticardiolipin titers were not cor related with normal cerebral blood flow.