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Lupus, Vol. 11, No. 1, 52-56 (2002)
DOI: 10.1191/0961203302lu137cr

Sustained normalization of cerebral blood-flow after iloprost therapy in a patient with neuropsychiatric systemic lupus erythematosus

A Mathieu

Center for Systemic Rheumatic Diseases, Cagliari, Italy; Cattedra di Reumatologia II, Centro per le Malattie Reumatiche Sistemiche, Dipartimento di Scienze Mediche, via San Giorgio 12, I-09100 Cagliari, Italymathieu{at}pacs.unica.it

G Sanna

A Mameli

C Pinna

A Vacca

A Cauli

G Passiu

Center for Systemic Rheumatic Diseases, Cagliari, Italy

M Piga

Center of Nuclear Medicine, Department of Medical Sciences, University of Cagliari, Cagliari, Italy

We report the case of a 30-year-old caucasian woman affected by SLE who developed neurological symptoms (prosopagnosia and visual-spatial agnosia) after nine years of disease. Brain MRI showed no abnormalities while a brain SPECT scan showed diffuse uptake defects and hypoperfusion areas in the right and left frontal-parietal regions. At that time the patient was on hydroxychloroquine (400 mg/day) and oral prednisolone (0.5 mg/kg/day) as maintenance therapy. One year later the patient showed worsening of Raynaud's phenomenon with digital dystrophic lesions and was therefore treated with an intravenous infusion of Iloprost (1.5 ng/kg/min per 6h/ day for 10 days consecutively), while baseline treatment remained unchanged. One month later the patient showed a dramatic improvement in her cognitive function and subsequent SPECT scans showed the gradual disappearance of perfusion abnormalities. This first report of Iloprost treatment in CNS lupus suggests the potential therapeutic usefulness of this drug in patients with SLE and functional CNS involvement.

Key Words: SLE • CNS • cognitive disorders • Iloprost • therapy • brain SPECT


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G Sanna, M L Bertolaccini, and A Mathieu
Central nervous system lupus: a clinical approach to therapy
Lupus, December 1, 2003; 12(12): 935 - 942.
[Abstract] [PDF]