Role of antiribosomal P protein antibodies in the diagnosis of lupus isolated to the central nervous system
M. A. Agius, J. W. Chan, S. Chung and E. K. Lee
Department of Neurology, University of California, Davis, USA.
BACKGROUND: When lupus presents with isolated central nervous system
findings, the usual serologic markers are often absent and diagnostic
difficulty with a delay in treatment is common. OBJECTIVE: To report the
usefulness of antiribosomal P protein antibodies in the diagnosis of lupus
isolated to the central nervous system when results of tests for
anti-double-stranded DNA antibodies are negative. DESIGN: Case report.
SETTING: University medical center. PATIENT: The patient was evaluated and
treated on referral and follow up for 1 year. RESULTS: We describe a
patient with acute onset of psychosis followed by coma and focal clonic
movements with undetectable DNA antibodies. Serum antiribosomal P protein
antibody levels were elevated. Steroid therapy was followed by marked
clinical improvement and a decrease in antibody titer. CONCLUSION:
Antiribosomal P protein antibodies provide an important confirmatory test
for the diagnosis of lupus isolated to the central nervous system when
results of tests for anti-double-stranded DNA antibodies are negative.
