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Treatment of Central Nervous System Lupus Erythematosus

JOHN S. SERGENT, M.D.; and MICHAEL D. LOCKSHIN, M.D., F.A.C.P.
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The Hospital for Special Surgery, New York, New York


Ann Intern Med. 1974;80(3):413-414. doi:10.7326/0003-4819-80-3-413_2
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Central nervous system (CNS) complications in patients with systemic lupus erythematosus are common and can be fatal (1, 2). Unlike lupus glomerulonephritis, lupus cerebritis is not characterized by reliable laboratory or clinical variables for diagnosis or prognosis. Tests for cerebrospinal fluid C4 (3) have not proved to be of practical clinical benefit (4).

Recognizing the frequent dilemma the clinician faces in differentiating CNS disease caused by underlying systemic lupus erythematosus from that caused by infection, azotemia, hypertension, or drug effects, proper therapy remains a formidable problem. Several groups have reported good therapeutic results using high doses of corticosteroids—from 500 to

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