Myocardial perfusion imaging using a technetium-99m sestamibi in asymptomatic and low risk for coronary artery disease patients with diagnosed systemic lupus erythematosus.

INTRODUCTION: The aim of the present study was to evaluate technetium-99m sestamibi single photon emission tomography (SPECT) myocardial perfusion imaging (MPI) and its association with some clinical and laboratory parameters in an asymptomatic systemic lupus erythematosus (SLE) population. MATERIALS AND METHODS: Twenty-one subjects with SLE and no suspected or documented coronary artery disease (CAD) accomplished myocardial perfusion imaging. Some SLE and CAD parameters were also evaluated in association with myocardial SPECT. RESULTS: Twenty-one women with a diagnosis of SLE (mean age 36.9 ± 12.8) entered the study. All patients were in the low-risk category for CAD pretest; however, abnormal myocardial perfusion results were found in eight (38%) patients. Amongst the traditional CAD risk factors, there was a significant association between the presence of dyslipidemia and myocardial perfusion abnormalities (P= 0.047). However, we found no significant association between other traditional and SLE-specific risk factors. CONCLUSION: This study's significant finding was that asymptomatic CAD is common in SLE patients, even in those thought to be low risk for CAD and in the absence of cardiac symptoms.

Neurological manifestations of Behçet's disease.

OBJECTIVE: To determine the prevalence, clinical manifestations, and laboratory features of Neuro-Behçet's disease. METHODS: This prospective study was carried out in the Behçet's Research Clinic in Shiraz (south-west Iran) and included the patients referred from 1990-1999. The patients' clinical records, images, CSF analyses, and electrodiagnostic studies were reviewed. RESULTS: Eighteen (15 males and 3 females) out of 690 Behcet s patients (2.6%, 95% CI = 1.4-3.8%) were found to have neurological involvement. The mean +/- standard deviation age of these patients was 34.7 +/- 8.6 years. All fulfilled the criteria of the International Study Group of Behcet s Disease. Central nervous system involvement was more common than peripheral nervous system manifestations. Headache, weakness, tingling, and numbness were the most common symptoms. Hyperreflexia, upward plantar reflex, and somatosensory findings were the most frequent signs. Hemispheral and brainstem stroke-like syndromes and cerebral venous thrombosis were the major neurologic presentations. There were also cases of myelitic, pure meningoencephalitic, amyotrophic lateral sclerosis-like, multiple sclerosis-like, and Guillain Barre syndromes. CONCLUSION: Neuro-Behçet's disease must be considered in the differential diagnosis of stroke in young adults, chronic meningitis, intracranial hypertension, multiple sclerosis, myelopathies, and peripheral neuropathies.

Neurological manifestations of Behcet`s disease.

OBJECTIVE: To determine the prevalence, clinical manifestations, and laboratory features of Neuro-Behcet`s disease. METHODS: This prospective study was carried out in the Behcet`s Research Clinic in Shiraz (south-west Iran) and included the patients referred from 1990-1999. The patients` clinical records, images, CSF analyses, and electrodiagnostic studies were reviewed. RESULTS: Eighteen (15 males and 3 females) out of 690 Behcet`s patients (2.6%, 95% CI = 1.4-3.8%) were found to have neurological involvement. The mean +/- standard deviation age of these patients was 34.7+/-8.6 years. All fulfilled the criteria of the International Study Group of Behcet`s Disease. Central nervous system involvement was more common than peripheral nervous system manifestations. Headache, weakness, tingling, and numbness were the most common symptoms. Hyperreflexia, upward plantar reflex, and somatosensory findings were the most frequent signs. Hemispheral and brainstem stroke-like syndromes and cerebral venous thrombosis were the major neurologic presentations. There were also cases of myelitic, pure meningoencephalitic, amyotrophic lateral sclerosis-like, multiple sclerosis-like, and Guillain Barre syndromes. CONCLUSION: Neuro-Behcet`s disease must be considered in the differential diagnosis of stroke in young adults, chronic meningitis, intracranial hypertension, multiple sclerosis, myelopathies, and peripheral neuropathies.

Association of amyotrophic lateral sclerosis and Behcet's disease: is there a relationship? A multi-national case series.

Neurological involvement may be seen in 5-30% of the patients with Behcet's disease (BD). Occasionally, parenchymal neurological involvement in BD can present as a spinal cord syndrome. However, motor neuron disease-like presentation is extremely uncommon. Here we are reporting five patients (all male; median age, 38) fulfilling both International Study Group criteria for BD and El Escorial criteria for amyotrophic lateral sclerosis (ALS). These patients were identified by a questionnaire sent to the members of the Neuro-Behcet Study Group of the International Study Group for BD. Three out of five patients had only motor presentations. In two patients, sensory and urinary manifestations were present as well. Spinal cord MRIs were normal in all, and brain MRIs were normal in four patients; one patient had nonspecific white matter changes. Two patients passed away 1-3 years after diagnosis of ALS, and two patients were lost to follow-up 3 and 11 years after admission; one patient is still alive 3 years after onset. The patients that are presented here might represent a rare form of neurological involvement in BD as well as sole coincidence. Larger prospective series are needed to further answer this issue.