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Fifty-six of our CNS patients had transient ischemic attacks or strokes,24 had epilepsy,and 12 had psychiatric disorders;the other 4 did not fulfill SLE criteria.In all,55%of patients(53)were found to be positive of aPL antibodies,whereas only 20%of the SLE control group were positive(P<0. 001).Based on a physicians'global clinical assessment tool together with laboratory analysis,only 42(44%)patients were found to be active at the onset of CNS manifestations,and the other 54(56%)were nonactive.A finding of aPL antibodies was associated strongly with the inactive CNS/SLE group (P=0.001).Of the 53 patients who underwent magnetic resonance imaging(MRI) study,33 showed small high-density lesions suggestive of vasculopathy. Twenty-six(79%)of them were positive for aPL antibodies;whereas of the 20 patients with normal MRIs,only 8(40%)were positive for aPL antibodies(P<0. 01).We confirm that CNS disease in SLE is significantly associated with the presence of aPL antibodies.The CNS manifestations can occur in about half of SLE patients without any other evidence of lupus activity.Abnormal MRIs highly correlate with positive aPL antibodies. |
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