Assessment of intrathecal injection with methotrexate and dexamethasone in treating lupus patients with central nervous system involvement / 中华神经科杂志

ABSTRACT

Objective To evaluate the intrathecal injection of combining methotrexate (MTX) and dexamethasone (DXM) into lupus patients with central nervous system involvement. Methods Twenty-eight cases of central nervous system involvement with systemic lupus erythematosus (SLE) accepted intrathecal injection of MTX plus DXM. Data including clinical manifestations, cerebrospinal fluid and skull CT or MRI before and after treatment were analyzed. Meanwhile, the mortalities between 28 cases treated with intrathecal injection and 57 cases received normal management without intrathecal injection were compared. Results Intrathecal injection of MTX plus DXM was given to 26 SLE-central nervous system (CNS) patients except 2 cases death. The symptoms and signs were remitted or relieved obviously including the decrease of pressure and protein and elevation of glucose in cerebrospinal fluid. Positive ANA in 6 cases had turned to negative after treatment. Conclusion Without any severe side effects, intrathecal injection with MTX plus DXM yielded satisfactory effects on patients with SLE-CNS, particularly in those with focus manifestations.