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To evaluate which serologic,cerebrospinal fluid(CSF),and neuroradiographic tests alone or in combination are most useful in the diagnosis of neuropsychiatric lupus erythematosus(NPLE).Specific tests for CSF antibodies are most useful diagnostically in diffuse NPLE,implicating autoantibodies in the pathogenesis of this NPLE presentation.In those patients with diffuse NPLE who present with primarily psychiatric disease, serum antiribosomal-P antibodies appear to be helpful.In contrast focal NPLE appears to be mostly secondary to vascular occlusion,and the presence of dermal vasculitis/livedo reticularis,antiphospholipid antibodies,and/or an abnormal cranial MRI-are most helpful diagnostically.Patients with complex presentations demonstrate abnormalities characteristic of both diffuse and focal NPLE.Abnormal tests can be followed serially and appear to correlate with clinical responses to therapy. |
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