Abstract
Anticardiolipin antibody (aCL) has been associated with thromboembolic phenomena, including stroke, in certain patients with systemic lupus erythematosus (SLE); however, the relation between this antibody and the central nervous system manifestations of SLE is unknown. Serum samples and cerebrospinal fluid from five patients with SLE and acute central nervous system manifestations were assayed for the presence of aCL. Anticardiolipin antibody was identified in sera from four of the five patients but in none of the cerebrospinal fluid samples. Nuclear magnetic resonance imaging showed 'infarct-like' lesions in these four patients. This preliminary study suggests that a correlation between serum aCL and cerebral infarcts in central nervous system lupus may potentially exist. From this limited study it seems unlikely that aCL has a direct pathogenic role in the diffuse encephalopathy of acute central nervous system lupus.
Full text
PDF



Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Adelman D. C., Saltiel E., Klinenberg J. R. The neuropsychiatric manifestations of systemic lupus erythematosus: an overview. Semin Arthritis Rheum. 1986 Feb;15(3):185–199. doi: 10.1016/0049-0172(86)90016-8. [DOI] [PubMed] [Google Scholar]
- Asherson R. A., Derksen R. H., Harris E. N., Bouma B. N., Gharavi A. E., Kater L., Hughes G. R. Chorea in systemic lupus erythematosus and "lupus-like" disease: association with antiphospholipid antibodies. Semin Arthritis Rheum. 1987 May;16(4):253–259. doi: 10.1016/0049-0172(87)90003-5. [DOI] [PubMed] [Google Scholar]
- Asherson R. A., Mercey D., Phillips G., Sheehan N., Gharavi A. E., Harris E. N., Hughes G. R. Recurrent stroke and multi-infarct dementia in systemic lupus erythematosus: association with antiphospholipid antibodies. Ann Rheum Dis. 1987 Aug;46(8):605–611. doi: 10.1136/ard.46.8.605. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bennahum D. A., Messner R. P. Recent observations on central nervous system lupus erythematosus. Semin Arthritis Rheum. 1975 Feb;4(3):253–266. doi: 10.1016/0049-0172(75)90012-8. [DOI] [PubMed] [Google Scholar]
- Bluestein H. G. Neuropsychiatric manifestations of systemic lupus erythematosus. N Engl J Med. 1987 Jul 30;317(5):309–311. doi: 10.1056/NEJM198707303170509. [DOI] [PubMed] [Google Scholar]
- Bluestein H. G., Williams G. W., Steinberg A. D. Cerebrospinal fluid antibodies to neuronal cells: association with neuropsychiatric manifestations of systemic lupus erythematosus. Am J Med. 1981 Feb;70(2):240–246. doi: 10.1016/0002-9343(81)90756-7. [DOI] [PubMed] [Google Scholar]
- Carreras L. O., Defreyn G., Machin S. J., Vermylen J., Deman R., Spitz B., Van Assche A. Arterial thrombosis, intrauterine death and "lupus" antiocoagulant: detection of immunoglobulin interfering with prostacyclin formation. Lancet. 1981 Jan 31;1(8214):244–246. doi: 10.1016/s0140-6736(81)92087-0. [DOI] [PubMed] [Google Scholar]
- Derksen R. H., Bouma B. N., Kater L. The association between the lupus anticoagulant and cerebral infarction in systemic lupus erythematosus. Scand J Rheumatol. 1986;15(2):179–184. doi: 10.3109/03009748609102086. [DOI] [PubMed] [Google Scholar]
- Derksen R. H., Bouma B. N., Kater L. The prevalence and clinical associations of the lupus anticoagulant in systemic lupus erythematosus. Scand J Rheumatol. 1987;16(3):185–192. doi: 10.3109/03009748709165272. [DOI] [PubMed] [Google Scholar]
- Elias M., Eldor A. Thromboembolism in patients with the 'lupus'-type circulating anticoagulant. Arch Intern Med. 1984 Mar;144(3):510–515. [PubMed] [Google Scholar]
- Ellis S. G., Verity M. A. Central nervous system involvement in systemic lupus erythematosus: a review of neuropathologic findings in 57 cases, 1955--1977. Semin Arthritis Rheum. 1979 Feb;8(3):212–221. doi: 10.1016/s0049-0172(79)80009-8. [DOI] [PubMed] [Google Scholar]
- Estes D., Christian C. L. The natural history of systemic lupus erythematosus by prospective analysis. Medicine (Baltimore) 1971 Mar;50(2):85–95. doi: 10.1097/00005792-197103000-00001. [DOI] [PubMed] [Google Scholar]
- Feinstein D. I. Lupus anticoagulant, thrombosis, and fetal loss. N Engl J Med. 1985 Nov 21;313(21):1348–1350. doi: 10.1056/NEJM198511213132109. [DOI] [PubMed] [Google Scholar]
- Gastineau D. A., Kazmier F. J., Nichols W. L., Bowie E. J. Lupus anticoagulant: an analysis of the clinical and laboratory features of 219 cases. Am J Hematol. 1985 Jul;19(3):265–275. doi: 10.1002/ajh.2830190308. [DOI] [PubMed] [Google Scholar]
- Golombek S. J., Graus F., Elkon K. B. Autoantibodies in the cerebrospinal fluid of patients with systemic lupus erythematosus. Arthritis Rheum. 1986 Sep;29(9):1090–1097. doi: 10.1002/art.1780290906. [DOI] [PubMed] [Google Scholar]
- Harris E. N., Gharavi A. E., Boey M. L., Patel B. M., Mackworth-Young C. G., Loizou S., Hughes G. R. Anticardiolipin antibodies: detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus. Lancet. 1983 Nov 26;2(8361):1211–1214. doi: 10.1016/s0140-6736(83)91267-9. [DOI] [PubMed] [Google Scholar]
- Harris E. N., Gharavi A. E., Loizou S., Derue G., Chan J. K., Patel B. M., Mackworth-Young C. G., Bunn C. C., Hughes G. R. Crossreactivity of antiphospholipid antibodies. J Clin Lab Immunol. 1985 Jan;16(1):1–6. [PubMed] [Google Scholar]
- Harris E. N., Loizou S., Englert H., Derue G., Chan J. K., Gharavi A. E., Hughes G. R. Anticardiolipin antibodies and lupus anticoagulant. Lancet. 1984 Nov 10;2(8411):1099–1099. doi: 10.1016/s0140-6736(84)91537-x. [DOI] [PubMed] [Google Scholar]
- Hart R. G., Miller V. T., Coull B. M., Bril V. Cerebral infarction associated with lupus anticoagulants--preliminary report. Stroke. 1984 Jan-Feb;15(1):114–118. doi: 10.1161/01.str.15.1.114. [DOI] [PubMed] [Google Scholar]
- Hull R. G., Harris E. N., Gharavi A. E., Tincani A., Asherson R. A., Valesini G., Denman A. M., Froude G., Hughes G. R. Anticardiolipin antibodies: occurrence in Behçet's syndrome. Ann Rheum Dis. 1984 Oct;43(5):746–748. doi: 10.1136/ard.43.5.746. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Keane A., Woods R., Dowding V., Roden D., Barry C. Anticardiolipin antibodies in rheumatoid arthritis. Br J Rheumatol. 1987 Oct;26(5):346–350. doi: 10.1093/rheumatology/26.5.346. [DOI] [PubMed] [Google Scholar]
- Kelly M. C., Denburg J. A. Cerebrospinal fluid immunoglobulins and neuronal antibodies in neuropsychiatric systemic lupus erythematosus and related conditions. J Rheumatol. 1987 Aug;14(4):740–744. [PubMed] [Google Scholar]
- Lechner K., Pabinger-Fasching I. Lupus anticoagulants and thrombosis. A study of 25 cases and review of the literature. Haemostasis. 1985;15(4):254–262. doi: 10.1159/000215157. [DOI] [PubMed] [Google Scholar]
- Loizou S., McCrea J. D., Rudge A. C., Reynolds R., Boyle C. C., Harris E. N. Measurement of anti-cardiolipin antibodies by an enzyme-linked immunosorbent assay (ELISA): standardization and quantitation of results. Clin Exp Immunol. 1985 Dec;62(3):738–745. [PMC free article] [PubMed] [Google Scholar]
- Mueh J. R., Herbst K. D., Rapaport S. I. Thrombosis in patients with the lupus anticoagulant. Ann Intern Med. 1980 Feb;92(2 Pt 1):156–159. doi: 10.7326/0003-4819-92-2-156. [DOI] [PubMed] [Google Scholar]
- Tan E. M., Cohen A. S., Fries J. F., Masi A. T., McShane D. J., Rothfield N. F., Schaller J. G., Talal N., Winchester R. J. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 Nov;25(11):1271–1277. doi: 10.1002/art.1780251101. [DOI] [PubMed] [Google Scholar]
- Triplett D. A., Brandt J. T., Musgrave K. A., Orr C. A. The relationship between lupus anticoagulants and antibodies to phospholipid. JAMA. 1988 Jan 22;259(4):550–554. [PubMed] [Google Scholar]
- Zvaifler N. J., Bluestein H. G. The pathogenesis of central nervous system manifestations of systemic lupus erythematosus. Arthritis Rheum. 1982 Jul;25(7):862–866. doi: 10.1002/art.1780250730. [DOI] [PubMed] [Google Scholar]