الفهرس 
Pathogenesis of SLEOnly 14 pages are availabe for public view
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Abstract
Central nervous system affection in SLE patients is one of the most common complications and causes
of death in lupus patients (Ko1•acs et a/., 1995).
Much evidence indicates that control of immune response and. consequently the
autoimmune disease is not· confined solely to the Immune system. In deed, a system
of bidierctional communication between the immune and neuroendocrinal systems exists
(Besedovsky et a/., 1995). The intrathecal synthesis of IL-6 in patients with SLE with CNS
involvement, which is a potent stimulator of PRL secretion, suggests a role for PRL
in pathogenesis of CNS manifestation of SLE (Jara et al., 1993).
Several mechanisms including immune mediated vasculopathy and neuron reactive autoantibodies (How
eta/., 1985) have been implicated in pathogenesis of CNS involvement.
There is no single test to date that serves as the gold standard for diagnosis of NPSLE (Hirrohata
eta/., 1985).
SPECT is a measure of brain perfusion SPECT is non-invasive enables anatomic imaging of lesion and
most important is mean of functional imaging. Alteral perfusion reflect abnormal function,
therefore we can get information regarding reversibility of a lesion by objectively documenting
improvement in perfusion (Julie et al., 1995). Aim of the work was to:
1- Predict CNS affection in SLE patients using SPECT.
2- To study the previous parameter as prognostic tool for CNS affection in SLE patients.
3- To study role ofPRL in CNS affection and disease activity.
4- To study role of anti-P-antibodies in pathogenesis of CNS affection in SLE patients.
Thirty SLE patients and 10 control were included m this study, SLE patients were categorized
into 3 groups:
group I with Major NPSLE (n = 7). group II with Minor NPSLE (n = 3). group III with No NPSLE (n =
20).
• We found abnormal SPECT scan in (83%) of group I and (33%) of group II, we found normal SPECT
scan in (72%) of group III and (I 00%) of the control group.
• We measured serum level of PRL hormone, we· found significant elevation of serum level of PRL in
SLE patients versus control group, highly significant correlation between, serum PRL and CNS
manifestation and disease activity score in SLE patients.
• We measured anti-P-antibodies in SLE patients. There was a highly significant difference in SLE
patients versus control group; we found no significant association between anti-P-antibodies and
CNS manifestations although high prevalence anti-P-antibodies were in patients with CNS
manifestation.
Conclusion: Our results confirm that SPECT imaging is a sensitive tool for diagnosis of CNS
involvement’s in SLE patients, while the meaning in
perfusion deficits in patients without neuropsychiatric symptoms remains to be clarified, the
domain of SPECT as a diagnostic tool may lie in the early detection of brain perli.1sion defects
such as headache and cognitive disorders.
• Prolactin hormone may serve as marker for active CNS lupus and disease activity.
• Anti-P-antibodies may serve as a good marker for diagnosis of SLE.