white matter changes

I hope you can answer a few questions for me.  I feel like I'm a ticking time bomb!

What causes white matter changes?
Should I be concerned that there are several new small lesions on my recent MRI?
Can anything be done to treat or prevent it?

I have a history of mild Lupus and have had 2 MRI's of the brain done due to memory loss and headaches. I do not have any other health issues. The second MRI, I requested because I wanted to see if it had gotten any worse.  I continue to have the memory problems, H/A, facial pain, joint pains, deep bone pain and low grade fever off and on.

MRI Results:
11/06 MRI - Punctate areas of increased T2 signal in the frontal subcortical white matter on both sides. These may represent chronic small vessel white matter ischemic change.
11/08 MRI - Probable very mild progression of deep white matter disease since 11/08/2006 examination with several new small lesions appearing.  There does not appear to have been a dramatic change since the previous exam.

My neurologist ask me to follow up with my rheumatologist because my ANA was 1:2560.
My MRI results were phoned to me "only minimal changes - F/U if any problems."

Any input or suggestions would be greatly appreciated.

Chirp12

[mini_d]

Hi Chirp12,

It is sad to note your problems. Joint pains, headache, facial pain, deep bone pain, low grade fever with ANA 1:2650- it is definitely suggestive of Systemic Lupus Erythematosus (SLE), if you are not using any drugs that can cause lups like symptoms (Procainamide, Hydralazine, isoniazid, chlorpromazine, methyldopa and others).

White mater changes can also occur due to SLE. Memory loss (due to white mater involvement) is one of the most frequent complications of CNS involvement in SLE. Diffuse changes on MRI including ischemic changes and white mater lesions can occur with SLE. These changes may at times progress, especially with active SLE. There is no specific treatment for the CNS changes alone, treatment of SLE on the whole with immunosuppressants will cause improvement.

Please visit your rheumatologist for treatment of SLE, and later approach your neurologist for further advice.

Do get back if you have other queries.

Regards