Cerebritis is defined as an inflammation of the cerebrum, a structure associated with memory, speech, etc., as a result of the formation of an abscess within the brain itself, found commonly in patients with lupus.
Systemic lupus
erythematosus (SLE) or Lupus is a chronic, autoimmune
disease as as a result of the development of
autoantibodies that attack the systems and organs in the
body.researchers at the indicated that saturated fatty acid palmitate,
but not unsaturated oleate, induces the
activation of the NLRP3-ASC inflammasome, causing caspase-1, IL-1β and
IL-18 production.
Lupus
cerebritis is a disorder of nervous system problems (an autoimmune
inflammatory disorder) caused
by lupus as as a result of the development of
autoantibodies that attack the systems and organs in the body. It causes
migraine headache, if the duration of the
central nervous system involvement last for a few minutes, or causes
dementia that can lead to neurological deficits as a transient attacks
or permanently.
Diagnosis
There is no specific standard for the diagnosis, bur some researchers suggested
the following
1. Serologic tests
Is the test to measure the levels of specific antibodies in a patient's
blood, the test is essential as the antinuclear antibody (ANA) titer is
positive in virtually all patients with this disorder, but some
researchers showed that serologic tests
are helpful in establishing the diagnosis of SLE and predicting disease
flares. However, there are few data on the relationship between the
onset of new organ involvement and lupus serologies, especially in children.(11)
2. Electroencephalography (EEG)
Electroencephalography (EEG) is to record
the measurement of voltage fluctuations resulting from ionic current
flows within the neurons of the brain. In a report of a 13-year-old girl
with a known diagnosis of systemic lupus erythematosus presented with seizures and psychosis. An electroencephalogram (EEG)
revealed continuous, non-evolving periodic lateralized epileptiform
discharges (PLEDs) in the left temporal region, which did not resolve
with benzodiazepine. A magnetic resonance imaging (MRI) brain scan
demonstrated a focal hyperintensity in the left medial temporal and left
occipital lobes, left thalamus and bilateral cerebellar white matter,
with evidence of vasculitis in the magnetic resonance angiography.
Intravenous immunoglobulin was given because of failed steroid therapy,
which resulted in a full resolution of clinical, EEG and MRI abnormalities. Lupus cerebritis
should be considered as a possible aetiology in (Focal (Nonepileptic)
Abnormalities on EEG) PLEDs, and immunoglobulin can be effective in
neuropsychiatric lupus.(14)
3. Computed tomography (CT scans)
In the study of thirty-four patients from the Jackson Memorial Hospital
and Miami Veterans Administration Medical Center complex with 4 or more
ARA criteria for SLE had CT of the brain. Of these patients with SLE, 14
had clinical features of cerebritis and 20 without cerebritis on
longterm steroid therapy served as controls. Clinical examinations were
performed by 1 of our group (NG). The CT of the brain was independently
read by 2 neuroradiologists (SO and RQ), whose only knowledge of the
patients was their age, sex and the diagnosis of SLE, showed that some
abnormality of the brain by CT was present in 11/14 patients during
their 1st attack of SLE cerebritis. At the initial presentation with SLE
cerebritis, 9 of 14 patients had marked cortical atrophy by CT and 2
had minimal cortical atrophy. At that time, a normal CT was found on 3
patients with SLE cerebritis. Two of these patients were on 30 and 40 mg
prednisone at the time of the normal CT. The 3rd had been on
corticosteroids previously but not in 4 months prior to the normal CT.
Corticosteroids were administered in all 3 patients and after remission
and reexacerbation of SLE cerebritis, repeat CT demonstrated development
of marked cortical atrophy in 2 of these patients and minimal cortical
atrophy in the other. The role of corticosteroids in their cortical
atrophy is unclear.(12)
4. A magnetic resonance imaging (MRI)
Most systemic lupus erythematosus patients having central nervous system
involvement tend to have abnormal MRI scans, as cerebral edema that can
occur due to cerebritis can be effectively identified by MRI scan(13)
5. Etc.
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Sources
(11) http://www.ncbi.nlm.nih.gov/pubmed/12634943
(12) http://www.rheum-care.com/shownews.asp?newsid=48
(13) http://www.lupussymptomsguide.com/lupus-cerebritis.html
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