Neuropsychiatric involvement in systemic lupus erythematosus

Central nervous system involvement in SLE may produce a variety of behavioral abnormalities, a number of which are seen in schizophrenic non-SLE patients. Thus, the possibility exists that at least some pathogenic mechanisms in classic schizophrenia may be similar to those suspected to be involved in the development of CNS-SLE. Currently, a number of such pathogenic mechanisms are under investigation in SLE. These include immune complex mediated phenomena, lymphocyte antibodies which cross react with brain antigens, specific antineuronal antibodies, and a direct or indirect effect of a viral agent. It is as yet unclear which, if any, of these mechanisms are involved in the development of the CNS disturbances seen in SLE. In addition, more than one such mechanism may be involved (including others as yet unsuspected) acting individually or together to produce CNS disturbances. Some of the possible interactions which may occur in the development of autoimmune CNS disease are outlined. The degree to which these mechanisms and interactions actually play a role in CNS disease is now under intensive investigation in our laboratories.