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[Objective] To clarify the clinical usefulness of cerebrospinal fluid (CSF) interleukin-6 (IL-6) measurement in patients with neuropsychiatric systemic lupus rythematosus (NPSLE), we studied CSF IL-6 ...levels in patients with NPSLE and analyzed the association between CSF IL-6 levels and other clinical findings of NPSLE. [Patients and Methods] We retrospectively analyzed records of 37 patients (33 females and four males) with NPSLE admitted to our hospital between January 2003 and December 2008. [Results] All patients showed neuropsychiatric symptoms. Fourteen patients showed abnormalities in brain magnetic resonance imaging (MRI) and 12 patients had abnormal findings in electroencephalography (EEG). Increased CSF cell counts and elevated levels of CSF IL-6 were found in 11 and 30 patients, respectively. Elevated levels of CSF IL-6 were not statistically correlated with specific abnormalities in the blood analysis, in increased CSF cell counts, and in abnormalities in the brain MRI and EEG. In addition, a group of NPSLE patients positive for antiphospholipid antibodies (aPL) showed lower CSF IL-6 than the patients negative for aPL. [Conclusion] These results indicated that CSF IL-6 might be useful in diagnosis of NPSLE. However, general assessments of patients based on various factors (clinical manifestations, imaging findings and CSF examinations) are also required.
【目的】全身性エリテマトーデス（SLE）における神経症状はループス腎炎と共に予後を左右する 重要な因子である．今回我々は中枢神経病変の評価における髄液IL-6 の有用性について臨床的検 討を行った．【対象及び方法】当院で神経症状合併SLE と診断した37 症例（男性４例，女性33 例）の臨床症状，血清免疫学的検査，髄液所見，頭部MRI 所見及び脳波所見に関して検討を行った．【結果】全例に精神神経症状，12 例に脳波異常，14例に頭部MRI 異常，11例に髄液細胞数増加，30例に髄液IL-6上昇を認めた．患者を髄液IL-6 上昇群と非上昇群とに分けて比較すると，神経症状（脳血管障害，脱髄性症候，頭痛，運動異常症，脊髄症，痙攣性疾患）及び精神症状（急性昏迷状態，不安症，認識障害，情動障害，精神障害）では両群間に有意差を認めず，脳波及び頭部MRI の異常所見も両群間に有意差を認めなかったが，髄液IL-6 上昇群では髄液細胞数が増加する傾向を認めた．一方血清補体価は髄液IL-6 上昇群で低下していた．更に抗リン脂質抗体陽性群と陰性群に分けて比較すると，陽性群では陰性群より髄液IL-6が低い傾向であった．【考察】SLE における神経症状の診断において髄液IL-6 の値は有用と考えられた．しかしながら髄液IL-6 非上昇群においても中枢神経症状の合併を認めており，髄液所見，画像診断を含めた総合的な評価が重要と考えられた．続きを見る
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Mendeley出力
