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Improvement of irregularity of brain vessel walls in systemic lupus erythematosus by tacrolimus

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Abstract

Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disease that affects multiple organs. Neuropsychiatric SLE develops during the course of the disease in 50% to 74% of SLE patients. The pathogenesis of CNS manifestations is multifactorial. The most common neuropathological finding has, in various studies, been multifocal infarcts. The cerebral vascular lesions in SLE that can cause cerebral infarction can be categorized into thromboembolism and vasculitis. On the other hand, tacrolimus is an immunosuppressive drug used for several autoimmune diseases, which inhibits the calcineurin pathway in T cells and reduces accompanying inflammatory cytokine production. We experienced that treatment of a patient with SLE with tacrolimus and steroid pulse therapy yielded improvement of vasculitis of brain vessels on magnetic resonance angiography. We suggest that tacrolimus may play an important role in the treatment of vasculitis of SLE.

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References

  1. Deepa G, Rajasheklar RS, Challa S et al (2007) Active necrotizing cerebral vasculitis in systemic lupus erythematosus. Neuropathology 27:561–565

    Article  Google Scholar 

  2. Hanly JG, Walsh NMG, Sangalang V (1992) Brain pathology in systemic lupus erythematosus. J Rheumatol 19:732–741

    PubMed  CAS  Google Scholar 

  3. Suzuki K, Kameda H, Amano K, et al. (2009) Single center prospective study of tacrolimus efficacy and safety in the treatment of various manifestations in systemic lupus erythematosus. Rheumatol Int (in press)

  4. Devinsky O, Petito CK, Alonso DR (1988) Clinical and neuropathological findings in systemic lupus erythematosus: the role of vasculitis, heart emboli, and thrombotic thrombocytopenic purpura. Ann Neurol 23:380–384

    Article  PubMed  CAS  Google Scholar 

  5. Ellis SG, Verity MA (1979) Central nervous system involvement in systemic lupus erythematosus: review of neuropathological findings in 57 cases 1955–1957. Semin Arthritis Reum 8:212–221

    Article  CAS  Google Scholar 

  6. Suzuki Y, Kitagawa Y, Matsuoka Y, Fukuda J, Mizushima Y (1990) Severe cerebral and systemic necrotizing vasculitis developing during pregnancy in a case of systemic lupus erythematosus. J Rheumatol 17:1408–1411

    PubMed  CAS  Google Scholar 

  7. Suwabe H, Moriuchi J, Hoshina Y, Iwata Y, Ichikawa Y, Arimori S (1993) Renal and cerebral infarctions in a patient with systemic lupus erythematosus without antiphospholipid antibodies. Reumachi 33:335–340

    CAS  Google Scholar 

  8. Wolf J, Neidermaier N, Bergner R, Lowitzsch K (2001) Cerebral vasculitis as the initial manifestation of systemic lupus erythematosus. Dtsch Med Wochenschr 126:947–950

    Article  PubMed  CAS  Google Scholar 

  9. Mimenza-Alvarado AJ, Tellez-Zenteno JF, Cantu-Brito C, Garcia-Ramos G (2002) Systemic lupus erythematosus with affection to brainstem: report of three cases. Rev Neurol 35:128–131

    PubMed  CAS  Google Scholar 

  10. Sipek-Dolnicar A, Hojnik M, Bozic B, Vizjak A, Rozman B, Ferluga D (2002) Clinical presentations and vascular histopathology in autopsied patients with systemic lupus erythematosus and anticardiolipin antibodies. Clin Exp Rheumatol 20:335–342

    PubMed  CAS  Google Scholar 

  11. D’Cruz D (1998) Vasculitis in systemic lupus erythematosus. Lupus 7:270–274

    Article  PubMed  Google Scholar 

  12. Meroni PL, Tincani A, Sepp N et al (2003) Endothelium and the brain in CNS lupus. Lupus 12:919–928

    Article  PubMed  CAS  Google Scholar 

  13. Appel GB, Pirani C, D’Agati V (1994) Renal vascular complications of systemic lupus erythematosus. J Am Soc Nephrol 4:1499–1515

    PubMed  CAS  Google Scholar 

  14. Jayne D (2004) The clinical features and pathology of vasculitis associated with anti-myeloperoxidase autoantibodies. Jpn J Infect Dis 57:S16–S17

    PubMed  Google Scholar 

  15. Carlson JA, Chen KR (2007) Cutaneous vasculitis update: neutrophilic muscular vessel and eosinophilic, granulomatous, and lymphocytic vasculitis syndromes. Am J Dermatopathol 29:32–43

    Article  PubMed  Google Scholar 

  16. Carlson JA, Chen KR (2006) Cutaneous vasculitis update: small vessel neutrophilic vasculitis syndromes. Am J Dermatopathol 28:486–506

    Article  PubMed  Google Scholar 

  17. Sunderkotter C, Bonsmann G, Sindrilaru A et al (2005) Management of leukocytoclastic vasculitis. J Dermatolog Terat 16:193–206

    Article  CAS  Google Scholar 

  18. Hashimoto H, Maekawa S, Nasu H, Okada T, Shiokawa Y, Fukuda Y (1984) Systemic vascular lesions and prognosis in systemic lupus erythematosus. Scand J Rheumatol 13(1):45–55

    Article  PubMed  CAS  Google Scholar 

  19. Kallenberg CGM, Heeringa P (1998) Pathogenesis of vasculitis. Lupus 7:280–284

    Article  PubMed  CAS  Google Scholar 

  20. Calamia KT, Balavanova M (2004) Vasculitis in systemic lupus erythematosus. Clin Dermatol 22:148–156

    Article  PubMed  Google Scholar 

  21. Bruce IN (2005) Atherogenesis and autoimmune disease: the model of lupus. Lupus 14:687–690

    Article  PubMed  CAS  Google Scholar 

  22. Tenedios F, Erkan D, Lockshin MD (2005) Cardiac involvement in the antiphospholipid syndrome. Lupus 14:691–696

    Article  PubMed  CAS  Google Scholar 

  23. Van Leuven SI, Kastelein JJ, D’Cruz DP et al (2006) Atherogenesis in rheumatology. Lupus 15:117–121

    Article  PubMed  Google Scholar 

  24. Duddridge M, Powell RJ (1997) Treatment of severe and difficult cases of systemic lupus erythematosus with tacrolimus. A report of three cases. Ann Rheum Dis 56:690–692

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Hiroaki Dobashi.

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Kizu, H., Dobashi, H., Kameda, T. et al. Improvement of irregularity of brain vessel walls in systemic lupus erythematosus by tacrolimus. Clin Rheumatol 30, 715–718 (2011). https://doi.org/10.1007/s10067-010-1591-3

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  • DOI: https://doi.org/10.1007/s10067-010-1591-3

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