Antineurofilament antibody evaluation in neuropsychiatric systemic lupus erythematosus

Authors

  • Mark L. Robbins MD,

    1. Departments of Medicine, Neurology, Pathology, and Radiology, The University of Wisconsin Hospital and Clinics, and the William S. Middleton Veterans Administration Hospital, Madison, Wisconsin.
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  • Steven E. Kornguth PhD,

    1. Departments of Medicine, Neurology, Pathology, and Radiology, The University of Wisconsin Hospital and Clinics, and the William S. Middleton Veterans Administration Hospital, Madison, Wisconsin.
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  • Carolyn L. Bell MD,

    1. Departments of Medicine, Neurology, Pathology, and Radiology, The University of Wisconsin Hospital and Clinics, and the William S. Middleton Veterans Administration Hospital, Madison, Wisconsin.
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  • Tom Kalinke BS,

    1. Departments of Medicine, Neurology, Pathology, and Radiology, The University of Wisconsin Hospital and Clinics, and the William S. Middleton Veterans Administration Hospital, Madison, Wisconsin.
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  • Douglas England MD,

    1. Departments of Medicine, Neurology, Pathology, and Radiology, The University of Wisconsin Hospital and Clinics, and the William S. Middleton Veterans Administration Hospital, Madison, Wisconsin.
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  • Patrick Turski MD,

    1. Departments of Medicine, Neurology, Pathology, and Radiology, The University of Wisconsin Hospital and Clinics, and the William S. Middleton Veterans Administration Hospital, Madison, Wisconsin.
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  • Frank M. Graziano MD, PhD

    Corresponding author
    1. Departments of Medicine, Neurology, Pathology, and Radiology, The University of Wisconsin Hospital and Clinics, and the William S. Middleton Veterans Administration Hospital, Madison, Wisconsin.
    Current affiliation:
    1. Harvard Community Health Plan, Kenmore Center, Two Fenway Plaza, Boston, MA 02215
    • Department of Medicine, Section of Rheumatology, The University of Wisconsin Hospital and Clinics, 600 Highland Avenue, Madison, WI 53792
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Abstract

We used Western blot analysis to examine the occurrence and titer of antibody to cytoskeletal neurofilament protein antigens in patients with neuropsychiatric manifestations of systemic lupus erythematosus (SLE) and in controls. Twenty-two patients with neuropsychiatric SLE (NPSLE) had an increased incidence of antineurofilament antibody (ANFA) compared with 34 patients with SLE without neuropsychiatric symptoms, 78 patients with other disease processes, and 22 healthy controls. ANFA were found to be directed against the 205,000- and 160,000-dalton proteins of the neurofilament triplet. Patients with a diffuse NPSLE clinical presentation had the greatest frequency of serum ANFA (7 of 12, 58%) compared with all other groups examined. Magnetic resonance imaging and serum anticardiolipin antibody testing were also performed in selected patients with NPSLE. Patients with a focal clinical presentation of NPSLE, positive magnetic resonance imaging findings, and negative serum ANFA had significantly elevated levels of anticardiolipin antibody.

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