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Analysis of structural changes in gray and white matter by magnetic resonance in juvenile systemic lupus erythematosus

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Aline Tamires Lapa
Total Authors: 1
Document type: Master's Dissertation
Press: Campinas, SP.
Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
Defense date:
Examining board members:
Simone Appenzeller; Maura Mikie Fukujima Goto; Eduardo Ferreira Borba Neto
Advisor: Simone Appenzeller

Systemic lupus erythematosus (SLE) is an autoimmune disease and multisystem. About 15-20% of SLE patients develop the disease in childhood and adolescence. The involvement of the central nervous system (CNS) is frequent. However, often it is observed a dissociation between clinical and neuroimaging findings. Some biomarkers associated with neuronal injury have been associated with neuropsychiatric SLE, but their roles in the pathogenesis and its validity and clinical applicability has not been studied in patients cSLE. Objective: To determine the prevalence of neuropsychiatric (NP) manifestations in SLE analyze the prevalence of structural changes and white matter lesions on magnetic resonance imaging (MRI), in addition to determining whether S100B and NF- H may be associated with structural changes and white matter lesion in JSLE patients and controls. Methods: Clinical, laboratory and medication use were assessed. Disease activity was assessed by SLEDAI (SLE Disease Activity Index) and the cumulative damage was analyzed by SDI (Lupus International Collaborating Clinics / American College of Rheumatology Damage Index). Mood disorders were determined through the Depression inventory (BDI) and anxiety (BAI) and Beck's cognitive disturbances were assessed by the Wechsler intelligence test according to age. The NP manifestations were analyzed by reviewing medical records. Neuropsychiatric symptoms were considered present early in the illness when they occurred in the first six months of disease and evolution, as occurred after this period. Patients and controls underwent MRI. The dosage of the markers was performed by ELISA (Enzyme Linked Immuno Sorbent Assay. Results: 71 patients were included in the retrospective study and 51 patients were included in cross-sectional study. 11 Both studies included patients with cSLE. Observed that early in the disease manifestations were NP present in 49 (69.01%) patients and progress in 56 (78.87%) patients.'s white matter lesions were identified in 44 (86%) patients and in 4 (8%) controls (p <0.001 ). Both the number (1029 vs number = 44) and volume of lesions (volume = volume = 1870.559 35796.458 vs mm ³) was significantly higher in patients with cSLE than in controls (p <0.001). atrophy of corpus callosum was identified in six cases (11.76%) (p = 0.005) and atrophy of brain volume was found in 7 (13.72%) and no control. Ten (19.61%) patients had a volume ventricular increased. Serum S100B and NF-H were increased in JSLE (148.98 ± 102.73pg/mL; 101.80 ± 89.40 pg/mL respectively) when compared to controls (48.10 ± 38.52 pg/mL; 57.12 ± 13.28 pg/mL respectively) (p<0.001; p=0.038 respectively). Conclusion: According to our results, the NP manifestations and white matter lesions are frequent in patients with JSLE. Corps callosum and brain volume in patients are significantly lower than the controls and the ventricle volume was significantly higher in patients compared to controls, indicating cerebral atrophy. Serum S100? and NF-H are increased in patients cSLE, indicating injury neuronal (AU)

FAPESP's process: 10/13639-1 - Analysis of structural changes in gray and white matter by magnetic resonance in juvenile systemic lupus erythematosus.
Grantee:Aline Tamires Lapa
Support Opportunities: Scholarships in Brazil - Master