Antiganglioside antibodies in cerebrospinal fluid of children with neuropsychiatric lupus erythematosus.

OBJECTIVE

To determine antiganglioside antibodies (AGA) in cerebrospinal fluid (CSF) of children with neuropsychiatric lupus erythematosus (NPLE), and to investigate their association with clinical manifestations and other laboratory tests.

METHODS

An enzyme linked immunoabsorbent assay was used to detect AGA in 22 CSF samples obtained from 18 children with systemic lupus erythematosus (SLE). These patients were further classified into clinical active NPLE (9 patients) and SLE (9 patients) groups. Indirect immunofluorescent assay was used for determination of CSF antinucleus antibodies (ANA).

RESULTS

AGA could be found in CSF of all the 9 active NPLE children who had neuropsychiatric manifestations within 6 months before or after AGA was tested. A clear association was observed between AGA and brain CT scan. No detectable ANA was found in CSF samples even though high titer of ANA was present in corresponding serum samples of SLE patients.

CONCLUSION

Detection of AGAs in CSF, more sensitive and specific than routine CSF examination and EEG, and positively associated with brain CT scan, is a simple and practical test for early judgment of childhood NPLE.