ROLE OF ANTIRIBOSOMAL P-PROTEIN ANTIBODIES IN THE DIAGNOSIS OF LUPUS ISOLATED TO THE CENTRAL-NERVOUS-SYSTEM

Background: When lupus presents with isolated central nervous system f indings, the usual serologic markers are often absent and diagnostic d ifficulty with a delay in treatment is common. Objective: To report th e usefulness of antiribosomal P protein antibodies in the diagnosis of lupus isolated to the central nervous system when results of tests fo r anti-double-stranded DNA antibodies are negative. Design: Case repor t. Setting: University medical center. Patient: The patient was evalua ted and treated on referral and followed up for 1 year. Result: We des cribe a patient with acute onset of psychosis followed by coma and foc al clonic movements with undetectable DNA antibodies. Serum antiriboso mal P protein antibody levels were elevated. Steroid therapy was follo wed by marked clinical improvement and a decrease in antibody titer. C onclusion: Antiribosomal P protein antibodies provide an important con firmatory test for the diagnosis of lupus isolated to the central nerv ous system when results of tests for anti-double-stranded DNA antibodi es are negative.