Cerebrospinal fluid orexin-A levels in systemic lupus erythematosus patients presenting with excessive daytime sleepiness

Lupus
K SuzukiTakashi Kanbayashi

Abstract

Objective Involvement of the hypothalamus is rare in patients with systemic lupus erythematosus (SLE). In this study, we measured cerebrospinal fluid (CSF) orexin-A levels in SLE patients with hypothalamic lesions to investigate whether the orexin system plays a role in SLE patients with hypothalamic lesions who present with excessive daytime sleepiness (EDS). Methods Orexin-A levels were measured in CSF from four patients with SLE who presented with hypothalamic lesions detected by MRI. Three patients underwent repeated CSF testing. All patients met the updated American College of Rheumatology revised criteria for SLE. Results Tests for serum anti-aquaporin-4 antibodies, CSF myelin basic protein and CSF oligoclonal bands were negative in all patients. All patients presented with EDS. Low to intermediate CSF orexin-A levels (92-180 pg/ml) were observed in three patients in the acute stage, two of whom (patients 1 and 2) underwent repeated testing and showed increased CSF orexin-A levels, reduced abnormal hypothalamic lesion intensities detected by MRI and EDS dissipation at follow-up. In contrast, CSF orexin-A levels were normal in one patient (patient 4) while in the acute stage and at follow-up, despite improvements in EDS an...Continue Reading

References

Jan 1, 2000·Lancet·S NishinoE Mignot
Nov 24, 2001·Trends in Neurosciences·C B SaperT E Scammell
Aug 21, 2007·Lancet Neurology·Dean M WingerchukBrian G Weinshenker
Feb 8, 2011·Current Neurology and Neuroscience Reports·Takashi KanbayashiSeiji Nishino
Mar 2, 2011·Arthritis and Rheumatism·J LuyendijkM A van Buchem
Jun 3, 2014·Lancet·Larissa LisnevskaiaDavid Isenberg
Sep 10, 2014·Nature Reviews. Neurology·Hélène Jeltsch-David, Sylviane Muller
Oct 11, 2014·Nature Reviews. Neuroscience·Takeshi Sakurai
Dec 24, 2014·Multiple Sclerosis : Clinical and Laboratory Research·Ruth Ann MarrieMaria Trojano

❮ Previous
Next ❯

Related Concepts

Related Feeds

CSF & Lymphatic System

This feed focuses on Cerebral Spinal Fluid (CSF) and the lymphatic system. Discover the latest papers using imaging techniques to track CSF outflow into the lymphatic system in animal models.