Accuracy of cerebrospinal fluid IL-6 testing for diagnosis of lupus psychosis. A multicenter retrospective study

Abstract

Psychiatric manifestations are relatively common in systemic lupus erythematosus (SLE) patients. Since there are factors causing psychiatric manifestations other than SLE, the diagnosis of lupus psychosis (LP) is often difficult. Previous studies disclosed that cerebrospinal fluid (CSF) IL-6 was elevated in SLE patients with neuropsychiatric manifestation. The current studies were therefore designed to examine the efficacy of CSF IL-6 in diagnosis of LP. Multicenter retrospective study was performed with 45 SLE patients who showed psychiatric manifestations between 1993 and 2000. The diagnosis of LP and psychosis due to causes other than SLE (non-LP) was confirmed by retrospective review of the clinical records. Thirty-two of the 45 patients were reconfirmed as LP in the retrospective study. Receiver operating characteristic curve analysis revealed that the sensitivity and specificity of CSF IL-6 for diagnosis of LP were 87.5% and 92.3%, respectively, at the cut-off value of 4.3 pg/ml. These results indicate that CSF IL-6 might be an effective measure in diagnosing LP, although exclusion of infectious meningoencephalitis and cerebrovascular accident is necessary.

Histopathological analysis of cerebral hemorrhage in systemic lupus erythematosus complicated with antiphospholipid syndrome

“…However, her neuropsychiatric manifestations were only partially attenuated by the operation. Cerebrospinal fluid (CSF) examination revealed elevation of interleukin-6 (IL-6) (36 pg/ml [normal: \4.3]) [11], anti-neuronal antibodies (5.94 U/ml [normal: \0.27]) [12], and anti-NR2 glutamate receptor antibodies (0.77 U/ml [normal: \0.25]) [13], leading to a diagnosis of lupus psychosis. Her akinetic mutism was gradually attenuated after the steroid therapy, so that she could respond to verbal commands by June 24; along with this, there was a decrease in CSF IL-6 and anti-neuronal antibodies.…”

Cytokines and Systemic Lupus Erythematosus

“…Furthermore, when IL-6 activity was followed throughout symptom remission, they noted a decrease in CSF IL-6 activity measured indirectly, but not in serum IL-6 activity (Hirohata & Miyamoto 1990). A recent study has shown that the sensitivity and specificity of CSF IL-6 for diagnosis of lupus psychosis was 87.5% and 92.3%, respectively, indicating that CSF IL-6 might be an effective marker for the diagnosis of lupus psychosis (Hirohata et al 2009). Although some cytokines are important biomarkers of NPSLE, the mechanism for the elevated levels of cytokines is thus far unknown.…”

Efficiency of tocilizumab therapy for an exacerbation of systemic lupus erythematosus: A case report and a review of literature

“…В нескольких ис-следованиях выявлена корреляция между повышением уровня ИЛ6, активностью СКВ и увеличением концентра-ции анти-ДНК [32,33]. В дополнение к системным эффек-там ИЛ6 может действовать локально, что подтверждается его присутствием в спинномозговой жидкости у пациентов с поражением ЦНС (нейролюпус) [34]. ТЦЗ отличается удовлетворительным профилем безопасности и может рас-сматриваться как альтернативный метод терапии СКВ при недостаточном эффекте ГК, цитостатиков и РТМ.…”