Schenatto C B, Xavier R M, Bredemeier M, Portela L V C, Tort A B L, Dedavid e Silva T L, Souza D O, Brenol J C T
Division of Rheumatology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Ann Rheum Dis. 2006 Jun;65(6):829-31. doi: 10.1136/ard.2005.048330.
To test serum S100B protein levels in patients with and without neuropsychiatric systemic lupus erythematosus (NPSLE) and controls.
87 patients with SLE, 23 with and 64 without neuropsychiatric involvement, and 25 control subjects were prospectively evaluated. NPSLE diagnosis was made according to the American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Serum S100B protein levels were determined with a luminescence immunoassay. Statistical analysis was performed using Mann-Whitney and Kruskal-Wallis tests.
Among the patients with NPSLE, 9 presented psychosis; 4, cranial neuropathy; 3, cerebrovascular disease; 1, seizures; 1, chorea; 1, peripheral polyneuropathy; 1, multiplex mononeuropathy; 3, dementia. Serum concentrations of S100B protein were significantly higher in patients with NPSLE (median 0.164 ng/ml, interquartile range 0.113-0.332) than in non-NPSLE patients (0.062 ng/ml, 0.026-0.109) and controls (0.088 ng/ml, 0.013-0.124) (p<0.001). Patients with anti-dsDNA antibodies had higher S100B protein levels (p = 0.001). No significant associations were found of lupus activity (among non-NPSLE cases), antiphospholipid antibodies, and reduced complement levels with S100B concentration.
Serum S100B protein level is raised in NPSLE, reflecting continuing neurological damage. The association of anti-dsDNA antibodies with higher S100B protein concentration deserves further study.
检测患与未患神经精神性系统性红斑狼疮(NPSLE)的患者及对照组的血清S100B蛋白水平。
对87例系统性红斑狼疮患者进行前瞻性评估,其中23例有神经精神受累,64例无神经精神受累,另设25例对照受试者。NPSLE诊断依据美国风湿病学会神经精神性狼疮综合征的命名法和病例定义。采用发光免疫分析法测定血清S100B蛋白水平。使用Mann-Whitney检验和Kruskal-Wallis检验进行统计学分析。
在NPSLE患者中,9例出现精神病;4例出现颅神经病变;3例出现脑血管疾病;1例出现癫痫;1例出现舞蹈病;1例出现周围性多发性神经病;1例出现多灶性单神经病;3例出现痴呆。NPSLE患者血清S100B蛋白浓度(中位数0.164 ng/ml,四分位间距0.113 - 0.332)显著高于非NPSLE患者(0.062 ng/ml,0.026 - 0.109)和对照组(0.088 ng/ml,0.013 - 0.124)(p<0.001)。抗双链DNA抗体阳性的患者S100B蛋白水平更高(p = 0.001)。未发现狼疮活动(非NPSLE病例中)、抗磷脂抗体及补体水平降低与S100B浓度之间存在显著关联。
NPSLE患者血清S100B蛋白水平升高,反映神经持续受损。抗双链DNA抗体与较高S100B蛋白浓度之间的关联值得进一步研究。