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Usefulness of Tc-99m ECD brain SPECT to evaluate the effects of methylprednisolone pulse therapy in lupus erythematosus with brain involvement: a preliminary report

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Abstract

Methylprednisolone pulse therapy (MPT) was introduced to avoid life-threatening complications in systemic lupus erythematosus (SLE) with brain manifestations. However, its efficacy in SLE patients remains uncertain and needs to be objectively evaluated. In this study, technetium-99m ethyl cysteinate dimer (Tc-99m ECD) brain single photon emission computed tomography (SPECT) was used to detect regional cerebral blood flow (rCBF) in SLE patients with normal brain magnetic resonance imaging (MRI) findings. Twelve female SLE patients with neuropsychiatric symptoms were enrolled in this study. All patients had normal brain MRI and abnormal Tc-99m ECD brain SPECT findings. The Tc-99m ECD brain SPECT studies were performed 2 weeks after MPT. Pre- and post-MPT serum levels of anticardiolipin antibodies (ACA) and antiribosomal P antibodies (anti-P) were also measured. Before MPT, four patients had positive ACA and seven had positive anti-P. After MPT, all 12 patients demonstrated negative serologic findings and no neuropsychiatric symptoms. After MPT, ten patients showed complete recovery and two showed partial recovery of rCBF in the follow-up Tc-99m ECD brain SPECT images. This imaging is a logical and objective tool for measuring the effects of MPT in SLE patients with brain involvement by the determination of rCBF changes.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan

    F. Y. Liu

  2. Department of Nuclear Medicine, National Defense Medical Center, Tri-Service General Hospital, No. 325, Sec. 2, Cherng-Kung Rd., Taipei, 114, Taiwan

    W. S. Huang

  3. Department of Nuclear Medicine, China Medicine College Hospital, Taichung, Taiwan

    C. H. Kao

  4. Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan

    R. F. Yen

  5. Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan

    J. J. Wang

  6. School of Medicine, National Defense Medical Center, Taipei, Taiwan

    S. T. Ho

Authors
  1. F. Y. Liu
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  2. W. S. Huang
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  3. C. H. Kao
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  4. R. F. Yen
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  5. J. J. Wang
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  6. S. T. Ho
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Correspondence to W. S. Huang.

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Liu, F.Y., Huang, W.S., Kao, C.H. et al. Usefulness of Tc-99m ECD brain SPECT to evaluate the effects of methylprednisolone pulse therapy in lupus erythematosus with brain involvement: a preliminary report. Rheumatol Int 23, 182–185 (2003). https://doi.org/10.1007/s00296-002-0282-z

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  • DOI: https://doi.org/10.1007/s00296-002-0282-z

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