What is the role of cerebrospinal fluid (CSF) analysis in the workup of CNS lupus?

Updated: May 04, 2021
  • Author: Pradeep C Bollu, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Cerebrospinal fluid (CSF) abnormalities have been seen in 30-40% of patients with systemic lupus erythematosus (SLE) reported. The frequency of CSF oligoclonal bands has varied between reports, with a lower range generally around 20%. An abnormal CSF is generally associated with a poor prognosis.

Cerebrospinal fluid (CSF) examination is most useful to exclude infection, especially in immunocompromised patients. However, the CSF can reflect increased central nervous system (CNS) lupus activity by showing elevated levels of white cells, protein, immunoglobulin synthesis, or absolute immunoglobulin G (IgG). Antineuronal nuclear antibodies have some value in confirming CNS disease when performed on CSF, but these are less specific or sensitive than a serum test.

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