IngentaConnect Fast Track Article: The clinical significance of micr...ith systemic lupus erythematosus

Authors: Carlos Cantú-Brito, José Fidel Baizabal-Carvallo, Marlene Alonso-Juárez, Guillermo García-Ramos

Abstract:

Background: Microembolic signals (MES) have been found in about 10% of patients with systemic lupus erythematosus (SLE), and have been associated with neuropsychiatric manifestations (NPSLE), including cerebrovascular damage. Objective: To determine the frequency of MES in patients with SLE, previous and further risk of neuropsychiatric manifestations. Methods: One hundred and nine consecutive patients with previous diagnosis of SLE and without acute neurological manifestations were evaluated clinically and by transcranial Doppler monitoring (1 hour) from November 2002 to March 2003. The baseline characteristics and outcomes were compared between patients with and without MES. Patients were followed during a mean time of 4.5 years, to detect the appearance of NPSLE, including stroke and transient ischemic attacks. Results: MES were detected in 16 patients (14.7%; range: 3–64/h); at baseline, previous neuropsychiatric manifestations were more frequent in patients with MES: 12/16 (75%) versus 46/92 (50%) (p=0.064), especially for cognitive dysfunction (p=0.036). Antiphospholipid syndrome and cardiovascular risk factors did not differ between groups at baseline and follow-up, neither the proportion of patients on antiplatelet agents. At follow-up, two patients from the MES positive group and six from the MES negative group developed a new neuropsychiatric manifestation (p=not significant). Conclusion: This study supports an association of MES and a history of NPSLE, especially cognitive dysfunction. MES were not associated with an increased risk of cerebral ischemia and other neurological manifestations at follow-up.

The clinical significance of microembolic signals in patients with systemic lupus erythematosus