Neuropsychiatric lupus erythematosus in a cohort of Egyptian patients

Abstract

Background The neuropsychiatric lupus erythematosus (NPSLE) is a severe complication of systemic lupus erythematosus (SLE) that is characterized by a variety of neurological manifestations involving both central and peripheral nervous system with variable mechanisms. This study aimed to investigate the frequency of NPSLE and its relation to other clinical and laboratory findings in SLE patients. Results We retrieved the medical records of 134 SLE patients during the study period; of them, 68 patients (50.7%) had NPSLE. Headache (55. 9%) was the most frequent NPSLE manifestation followed by seizures (54.4%), psychosis was the third most frequent one with a percentage of 41.2. The demographic data didn’t differ in patients with and without NPSLE. NPSLE patients had lower complement 3 (C3) (p = 0.025) and C4 (p = 0.008) levels, more lupus anticoagulant level (p = 0.033) and more frequency of antiphospholipid syndrome (p = 0.030). There was no statistical difference regarding the drug intake or other laboratory findings. Disease activity and damage indices didn’t differ in both groups. Conclusion The prevalence of NPSLE in this study was 50.7%. Headache, seizures and psychosis were the most frequent neuropsychiatric manifestations in the studied patients. SLE patients with neuropsychiatric manifestations had lower complement levels, higher lupus anticoagulant antibodies and antiphospholipid syndrome.

Prevalence of neuropsychiatric disorders in patients with systemic lupus erythematosus in Pakistan: A systematic review and meta-analysis

“…The findings of this meta-analysis are in line with the recent meta-analysis conducted in the Swiss lupus cohort study (28.1%) ( 63 ). However, pooled overall prevalence of NPSLE in Pakistan is significantly lower than in the studies conducted in Switzerland at 56.3% ( 64 ) and Egypt at 50.7% ( 65 ). This discrepancy could be attributed to the differences in research methodology, sample size, and universal definition of NPSLE disorders.…”

Characteristics of Neuropsychiatric Systemic Lupus Erythematous in Dr. Sardjito General Hospital

“…The most common symptoms of adult SLE, according to a previous study, were headaches, which ranged from 20% to 40%; cognitive disorder, which was present in 10% to 20% of cases; seizures; and cerebrovascular disease, both of which were present in 7-10% of cases. Anxiety disorder was present in 4%-8% of cases [5,24]. Another study found that depression is the most prevalent NP condition, affecting 10.8% to 39.6% of SLE patients (6).…”

“…Neuropsychiatric SLE (NPSLE) is a presentation of SLE which influences psychiatric and neurologic systems [4] and one of the least recognised aspects is neurologic and psychiatric. It is frequently linked to a bad prognosis [5]. According to findings in the literature, NPSLE affects between 27% and 80% of persons with SLE [6][7][8][9].…”