Castellazzi Massimiliano, Candeloro Raffaella, Pugliatti Maura, Govoni Marcello, Silvagni Ettore, Bortoluzzi Alessandra
Department of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy.
Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy.
Diagnostics (Basel). 2024 Jan 23;14(3):242. doi: 10.3390/diagnostics14030242.
The analysis of cerebrospinal fluid (CSF) remains a valuable diagnostic tool in the evaluation of inflammatory and infectious conditions involving the brain, spinal cord, and meninges. Since many rheumatic inflammatory diseases can involve the central and peripheral nervous system, the aims of this narrative review were to summarize the latest evidence on the use of CSF analysis in the field of neuropsychiatric manifestations of rheumatic diseases. Routine CSF parameters were taken into consideration for this review: appearance; total protein and cellular content (pleocytosis); lactate and/or glucose; CSF/serum albumin quotient; intrathecal synthesis of IgG. Data regarding the role of CSF analysis in the clinical management of neuropsychiatric systemic lupus erythematosus, primary Sjogren's syndrome, rheumatoid arthritis, and Behçet's syndrome are presented. Although no disease-specific picture has been identified, CSF analysis remains a useful diagnostic tool to confirm the presence of a neuro-inflammatory state or, conversely, to exclude the concomitant presence of other inflammatory/infectious diseases affecting the CNS in the context of systemic rheumatologic conditions.
脑脊液（CSF）分析仍然是评估涉及脑、脊髓和脑膜的炎症性和感染性疾病的一项重要诊断工具。由于许多风湿性炎症性疾病可累及中枢和周围神经系统，本叙述性综述的目的是总结在风湿性疾病神经精神表现领域中使用脑脊液分析的最新证据。本综述考虑了常规脑脊液参数：外观；总蛋白和细胞成分（细胞增多）；乳酸和/或葡萄糖；脑脊液/血清白蛋白商；鞘内IgG合成。文中介绍了脑脊液分析在神经精神性系统性红斑狼疮、原发性干燥综合征、类风湿关节炎和白塞病临床管理中的作用。尽管尚未发现特定疾病的特征，但脑脊液分析仍然是一种有用的诊断工具，可用于确认神经炎症状态的存在，或者相反，在全身性风湿性疾病的背景下排除影响中枢神经系统的其他炎症/感染性疾病的并存情况。
