Neuropsychiatric Features of a Cohort of Patients with Systemic Lupus Erythematosus

Abstract

In order to establish if neuropsychiatric systemic lupus erythematosus (NPSLE) can be identified by any characteristic other than those used to diagnose the neuropsychiatric (NP) disease itself, we retrospectively reviewed 98 systemic lupus erythematosus (SLE) patients followed over a mean period of 10 years. NPSLE was identified in 22 patients. Stroke and generalized seizures were the most frequent NP manifestations. The NPSLE and non-NPSLE groups were similar with regard to demographic characteristics, ACR criteria, serum autoantibodies, and frequency of hypertension and hypercholesterolemia. Of note, compared to the non-NPSLE group, NPSLE was associated with a higher frequency of smoking (78 versus 26%), organ damage (73 versus 34%), and cumulative mortality rate (14 versus 7%). The series of patients was further analysed according to the presence of antiphospholipid syndrome (APS). Significantly, the interval between the onset of NP disease and SLE diagnosis was shorter in the APS− (0.3 ± 1 years) than in the APS+ (5 ± 7 years) groups. Recurrence and/or persistence of NP events were only documented in the APS− group. Overall cumulative mortality was highest in NPSLE and in APS+ patients with inadequate anticoagulation control, identifying an aspect that requires improved vigilance and the development of novel therapeutic modalities.

Neuropsychiatric manifestations in a consecutive cohort of systemic lupus erythematosus; a single center study

“…The age of disease onset and duration of disease were not associated with NP‐SLE in this study. These findings were similar to previous studies and in contrast with one other study…”

Ultrasound detects subclinical joint inflammation in the hands and wrists of patients with systemic lupus erythematosus without musculoskeletal symptoms

“…Patients were sequentially recruited from the population of the two outpatient autoimmune disease units from Centro Hospitalar de Lisboa Central (Lisbon, Portugal) between January 2014 and July 2015. A subset of these patients has been previously characterised 20. We excluded patients with a known diagnosis of rhupus syndrome (defined as patients with SLE also satisfying the classification criteria for RA)21 or Jaccoud’s arthropathy and mild deforming arthropathy (according to the Jaccoud’s Arthropathy Index),4 22 as well as patients with known osteoarthritis, trauma or surgery of the hand or wrist.…”

Characterization of damage in Portuguese lupus patients

“…4 In comparison, although our cohort comprised a similar frequency of articular disease (approximately 70%), there was a higher frequency of neuropsychiatric (NP) disease (22%) than in the national register (11%). In addition, in our cohort, the patients with damage were enriched for NP disease (n ¼ 16/22, 72%) versus non-NP patients (n ¼ 17/76, 22%).…”