Cranial computerized tomography in systemic lupus erythematosus.

Twelve patients with active central nervous system systemic lupus erythematosus (CNS SLE) and 11 patients without CNS involvement, all taking corticosteroids, were studied by computerized tomography (CT). Thirty CT scans on 23 individuals were performed and read blindly and independently by 2 neuroradiologists with an 86% correlation. Minimal to moderate atrophy was the most frequent finding, both in CNS SLE and controls, severe atrophy seen in 1 patient only, and no atrophy in 3 patients and a single control. Of the 6 patients who had repeated scans, 4 showed no change in the degree of atrophy, 1 had more and 1 less atrophy. Three patients had evidence of multiple brain infarcts on scan with or without associated cerebral atrophy. Sequential scans in 1 of these patients showed total resolution of the infarcts after 30 months. Thus, there was no correlation between the presence of cerebral atrophy on CT scan and CNS SLE. Rather our findings suggest that steroids may be the cause of atrophy.