Cerebral microembolism, a disease marker for ischemic cerebrovascular events in the antiphospholipid syndrome of systemic lupus erythematosus?

Objectives - We investigated whether the detectability of microembolic Dopp ler signals (MES) in the intracranial circulation may help to define the in dividual cerebrovascular risk in systemic lupus erythematosus (SLE) with an tiphospholipid syndrome (APS). Material and methods - Retrospective cross-s ectional study of 70 patients with SLE with or without APS, and 30 controls with a history of cerebral ischemia of unknown cause. Of all patients, 38 had a clinical history of APS and 32 did not. Results - 15 patients with AP S (39%) showed MES. In contrast, all patients without APS and 29 of 30 cont rols were microemboli-negative. MES were more strongly associated with cere brovascular symptoms than with APS, antiphospholipid antibodies, or cardiac pathology. The time elapsed since the last ischemic cerebrovascular sympto m was significantly shorter in microemboli-positive patients than in microe mboli-negative patients (P < 0.001). Conclusion MES may be related to disea se activity in patients with SLE and APS. Their detection may help to asses s individual cerebrovascular risk and contribute to therapeutic decision ma king and therapeutic monitoring.