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Precipitating antibodies against the Ro(SS-A)antigen,determined by gel double-immunodiffusion,were present in an increased frequency in CNS-SS patients with(1)documented clinical CNS disease,(2)focal clinical CNS manifestations and serious complications,(3)large regions of increased signal intensity,consistent with ischemia/infarcts on brain MRI scans or regions of decreased attenuation consistent with infarcts on CT,and(4) abnormal cerebral angiograms consistent with small-vessel angiitis. Finally,the anti-Ro(SS-A)antibody response in CNS was directed against the 60-kd peptide specificity,determined by ELISA.Clinical,neuroimaging (cerebral CT)and angiographic observation suggest that a subset of anti-Ro (SS-A)antibody-positive,in contrast with negative,CNS-SS patients have more serious and extensive CNS disease,some with frank cerebral angiopathy.Anti-Ro(SS-A)antibodies are postulated to play a role in mediating or potentiating vascular injury in CNS-SS. |
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