From the Research
Cerebrospinal Fluid (CSF) Findings in Lupus Encephalitis
- Elevated CSF cyclic GMP (C-GMP) levels have been found in patients with systemic lupus erythematosus (SLE) and active neurologic disease 1.
- Other CSF findings, such as increased IgM, IgA, and IgG indexes, have also been observed in patients with CNS-SLE, and these indexes may decrease with successful treatment 2.
- Mild pleocytosis has been reported in some patients with SLE and CNS manifestations 3, 4.
- Intrathecal production of IgG has been observed in a subset of patients with SLE and CNS involvement 4, 2.
- Abnormal CSF findings have been correlated with poorer outcomes in patients with CNS-SLE 3.
- Elevated levels of interleukin (IL)-12 p40/p70, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, and IL-10 have been found in the CSF of patients with SLE and CNS manifestations, with IFN-γ being associated with cerebral atrophy 4.
- The presence of anti-glutamate receptor antibodies has been reported in a case of acute limbic encephalitis associated with SLE, suggesting a potential role in the pathogenesis of limbic encephalitis in SLE patients 5.
CSF Markers of Disease Activity
- Elevated CSF C-GMP levels may be a marker of active neurologic disease in SLE 1.
- Increased CSF IgM, IgA, and IgG indexes may reflect CNS disease activity in SLE and decrease with successful treatment 2.
- CSF IFN-γ levels have been correlated with cerebral volume reduction in SLE patients, suggesting a potential role in the pathogenesis of cerebral atrophy 4.