Brain magnetic resonance imaging in newly diagnosed systemic lupus erythematosus

Michelle Petri, Mohammad Naqibuddin, Kathryn Anne Carson, Daniel J. Wallace, Michael H. Weisman, Stephen L. Holliday, Margaret Sampedro, Shalini Narayana, Peter T. Fox, Crystal Franklin, Patriciaa Padilla, Robin L. Brey

Research output: Contribution to journalArticle

Abstract

Objective. We wished to determine the prevalence of cerebral atrophy and focal lesions in a cohort of patients with newly diagnosed systemic lupus erythematosus (SLE) and the association of these brain abnormalities with clinical characteristics. Methods. A total of 97 patients with SLE, within 9 months of diagnosis, with 4 or more American College of Rheumatology classification criteria, were enrolled. Brain magnetic resonance imaging was performed. Results. The patients were 97% female, mean age 38.1 (SD 12.2) years, education 15.1 (2.8) years; 59 Caucasian, 11 African American, 19 Hispanic, 5 Asian, and 3 other ethnicity. Cerebral atrophy was prevalent in 18% (95% CI 11%-27%): mild in 12%, moderate in 5%. Focal lesions were prevalent in 8% (95% CI 4%-16%): mild in 2%, moderate in 5%, severe in 1%. Patients with cerebral atrophy were more likely to have anxiety disorder (p = 0.04). Patients with focal lesions were more likely to be African American (p = 0.045) and had higher Safety of Estrogens in Lupus Erythematosus National Assessment SLEDAI scores (p = 0.02) and anti-dsDNA (p = 0.05). Conclusion. In this population with newly diagnosed SLE, brain abnormalities were prevalent in 25% of patients. These findings suggest that the brain may be affected extremely early in the course of SLE, even before the clinical diagnosis of SLE is made. Followup of these patients is planned, to determine the reversibility or progression of these abnormalities and their association with and potential predictive value for subsequent neuropsychiatric SLE manifestations.

Original languageEnglish (US)
Pages (from-to)2348-2354
Number of pages7
JournalJournal of Rheumatology
Volume35
Issue number12
DOIs
StatePublished - Dec 2008

Fingerprint

Systemic Lupus Erythematosus
Magnetic Resonance Imaging
Brain
Atrophy
African Americans
Central Nervous System Lupus Vasculitis
Anxiety Disorders
Hispanic Americans
Estrogens
Safety
Education
Population

Keywords

  • Cerebral atrophy
  • Magnetic resonance imaging
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy

Cite this

Petri, M., Naqibuddin, M., Carson, K. A., Wallace, D. J., Weisman, M. H., Holliday, S. L., ... Brey, R. L. (2008). Brain magnetic resonance imaging in newly diagnosed systemic lupus erythematosus. Journal of Rheumatology, 35(12), 2348-2354. https://doi.org/10.3899/jrheum.071010

Brain magnetic resonance imaging in newly diagnosed systemic lupus erythematosus. / Petri, Michelle; Naqibuddin, Mohammad; Carson, Kathryn Anne; Wallace, Daniel J.; Weisman, Michael H.; Holliday, Stephen L.; Sampedro, Margaret; Narayana, Shalini; Fox, Peter T.; Franklin, Crystal; Padilla, Patriciaa; Brey, Robin L.

In: Journal of Rheumatology, Vol. 35, No. 12, 12.2008, p. 2348-2354.

Research output: Contribution to journalArticle

Petri, M, Naqibuddin, M, Carson, KA, Wallace, DJ, Weisman, MH, Holliday, SL, Sampedro, M, Narayana, S, Fox, PT, Franklin, C, Padilla, P & Brey, RL 2008, 'Brain magnetic resonance imaging in newly diagnosed systemic lupus erythematosus', Journal of Rheumatology, vol. 35, no. 12, pp. 2348-2354. https://doi.org/10.3899/jrheum.071010
Petri, Michelle ; Naqibuddin, Mohammad ; Carson, Kathryn Anne ; Wallace, Daniel J. ; Weisman, Michael H. ; Holliday, Stephen L. ; Sampedro, Margaret ; Narayana, Shalini ; Fox, Peter T. ; Franklin, Crystal ; Padilla, Patriciaa ; Brey, Robin L. / Brain magnetic resonance imaging in newly diagnosed systemic lupus erythematosus. In: Journal of Rheumatology. 2008 ; Vol. 35, No. 12. pp. 2348-2354.
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abstract = "Objective. We wished to determine the prevalence of cerebral atrophy and focal lesions in a cohort of patients with newly diagnosed systemic lupus erythematosus (SLE) and the association of these brain abnormalities with clinical characteristics. Methods. A total of 97 patients with SLE, within 9 months of diagnosis, with 4 or more American College of Rheumatology classification criteria, were enrolled. Brain magnetic resonance imaging was performed. Results. The patients were 97{\%} female, mean age 38.1 (SD 12.2) years, education 15.1 (2.8) years; 59 Caucasian, 11 African American, 19 Hispanic, 5 Asian, and 3 other ethnicity. Cerebral atrophy was prevalent in 18{\%} (95{\%} CI 11{\%}-27{\%}): mild in 12{\%}, moderate in 5{\%}. Focal lesions were prevalent in 8{\%} (95{\%} CI 4{\%}-16{\%}): mild in 2{\%}, moderate in 5{\%}, severe in 1{\%}. Patients with cerebral atrophy were more likely to have anxiety disorder (p = 0.04). Patients with focal lesions were more likely to be African American (p = 0.045) and had higher Safety of Estrogens in Lupus Erythematosus National Assessment SLEDAI scores (p = 0.02) and anti-dsDNA (p = 0.05). Conclusion. In this population with newly diagnosed SLE, brain abnormalities were prevalent in 25{\%} of patients. These findings suggest that the brain may be affected extremely early in the course of SLE, even before the clinical diagnosis of SLE is made. Followup of these patients is planned, to determine the reversibility or progression of these abnormalities and their association with and potential predictive value for subsequent neuropsychiatric SLE manifestations.",
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AU - Petri, Michelle

AU - Naqibuddin, Mohammad

AU - Carson, Kathryn Anne

AU - Wallace, Daniel J.

AU - Weisman, Michael H.

AU - Holliday, Stephen L.

AU - Sampedro, Margaret

AU - Narayana, Shalini

AU - Fox, Peter T.

AU - Franklin, Crystal

AU - Padilla, Patriciaa

AU - Brey, Robin L.

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N2 - Objective. We wished to determine the prevalence of cerebral atrophy and focal lesions in a cohort of patients with newly diagnosed systemic lupus erythematosus (SLE) and the association of these brain abnormalities with clinical characteristics. Methods. A total of 97 patients with SLE, within 9 months of diagnosis, with 4 or more American College of Rheumatology classification criteria, were enrolled. Brain magnetic resonance imaging was performed. Results. The patients were 97% female, mean age 38.1 (SD 12.2) years, education 15.1 (2.8) years; 59 Caucasian, 11 African American, 19 Hispanic, 5 Asian, and 3 other ethnicity. Cerebral atrophy was prevalent in 18% (95% CI 11%-27%): mild in 12%, moderate in 5%. Focal lesions were prevalent in 8% (95% CI 4%-16%): mild in 2%, moderate in 5%, severe in 1%. Patients with cerebral atrophy were more likely to have anxiety disorder (p = 0.04). Patients with focal lesions were more likely to be African American (p = 0.045) and had higher Safety of Estrogens in Lupus Erythematosus National Assessment SLEDAI scores (p = 0.02) and anti-dsDNA (p = 0.05). Conclusion. In this population with newly diagnosed SLE, brain abnormalities were prevalent in 25% of patients. These findings suggest that the brain may be affected extremely early in the course of SLE, even before the clinical diagnosis of SLE is made. Followup of these patients is planned, to determine the reversibility or progression of these abnormalities and their association with and potential predictive value for subsequent neuropsychiatric SLE manifestations.

AB - Objective. We wished to determine the prevalence of cerebral atrophy and focal lesions in a cohort of patients with newly diagnosed systemic lupus erythematosus (SLE) and the association of these brain abnormalities with clinical characteristics. Methods. A total of 97 patients with SLE, within 9 months of diagnosis, with 4 or more American College of Rheumatology classification criteria, were enrolled. Brain magnetic resonance imaging was performed. Results. The patients were 97% female, mean age 38.1 (SD 12.2) years, education 15.1 (2.8) years; 59 Caucasian, 11 African American, 19 Hispanic, 5 Asian, and 3 other ethnicity. Cerebral atrophy was prevalent in 18% (95% CI 11%-27%): mild in 12%, moderate in 5%. Focal lesions were prevalent in 8% (95% CI 4%-16%): mild in 2%, moderate in 5%, severe in 1%. Patients with cerebral atrophy were more likely to have anxiety disorder (p = 0.04). Patients with focal lesions were more likely to be African American (p = 0.045) and had higher Safety of Estrogens in Lupus Erythematosus National Assessment SLEDAI scores (p = 0.02) and anti-dsDNA (p = 0.05). Conclusion. In this population with newly diagnosed SLE, brain abnormalities were prevalent in 25% of patients. These findings suggest that the brain may be affected extremely early in the course of SLE, even before the clinical diagnosis of SLE is made. Followup of these patients is planned, to determine the reversibility or progression of these abnormalities and their association with and potential predictive value for subsequent neuropsychiatric SLE manifestations.

KW - Cerebral atrophy

KW - Magnetic resonance imaging

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