Neuropsychiatric manifestations and their attribution to SLE: a retrospective single-center study in the Polish population

Pawlak-Buś, Katarzyna; Schmidt, Wiktor; Leszczyński, Piotr

doi:10.20452/pamw.16319

Cited by 4 publications

(3 citation statements)

References 34 publications

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“…No significant difference was found in the proportion of all organ involvements in NPSLE and non-NPSLE groups, unlike in Zhang et al ’s study that found a significant difference in the organ involvement 10 and Pawlak-Bus et al’ s study that reported a significantly higher proportion in vasculitis involvement in the NPSLE group. 12 …”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary re-evaluation of neuropsychiatric events to confirm the neuropsychiatric lupus diagnosis at an Indonesian tertiary hospital

Estiasari,

Banu,

Widhani

et al. 2024

Lupus Sci Med

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ObjectiveNeuropsychiatric SLE (NPSLE) has a broad spectrum and to date, there is no gold-standard biomarker. The diagnosis relies on clinical assessment, supporting examinations and exclusion of other possible aetiologies. One method that can be used to establish NPSLE is to conduct a re-evaluation by involving several fields of medical science. This study aims to reassess SLE cases with neuropsychiatric (NP) manifestations through multidisciplinary re-evaluation and determine the final diagnosis of NPSLE or non-NPSLE.MethodsThis retrospective cross-sectional study used medical record data from patients with SLE with NP manifestations. Inclusion criteria included patients diagnosed with SLE, who had clinical manifestations of NP and were >18 years old. Multidisciplinary re-evaluation was conducted and agreed upon the diagnosis of NPSLE or non-NPSLE.ResultsWe included 94 subjects with a total of 132 NP events consisting of 69 NPSLE and 63 non-NPSLE. After re-evaluating NPSLE events, 33.3% were still concluded to be NPSLE. Meanwhile, from the non-NPSLE group, 22.2% were then declared as NPSLE. There were no significant differences in demographic characteristics between the NPSLE and non-NPSLE groups. The proportion of NP events in both groups was almost the same except for cerebrovascular disease manifestations which were more common in the NPSLE group. Higher Mexican SLE Disease Activity Index scores with (p<0.001) or without NP (p=0.02) were observed in the NPSLE group compared with the non-NPSLE group, as well as higher proportion of active disease (p=0.03), higher anti-double-stranded DNA titres (p<0.001) and lower values of C3 (p=0.018) and C4 (p=0.001).ConclusionsMultidisciplinary re-evaluation can be used as a method to confirm the diagnosis of NPSLE. There is a tendency for overdiagnosis of NPSLE when clinicians are faced with NP events in patients with SLE. Complete clinical and supporting data are needed to determine the final diagnosis of NPSLE.

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Section: Discussionmentioning

confidence: 99%

Multidisciplinary re-evaluation of neuropsychiatric events to confirm the neuropsychiatric lupus diagnosis at an Indonesian tertiary hospital

Estiasari,

Banu,

Widhani

et al. 2024

Lupus Sci Med

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“…The greatest clinical value of HCQ was proven by numerous observational studies of SLE populations (Hopkins Lupus Cohort, GLADEL Cohort, Toronto Lupus Cohort). 15 -17 In current clinical practice, HCQ is the primary drug used in most patients with SLE, 70 and it is recommended regardless of the clinical manifestation and disease activity. 18, 71 The HCQ treatment often lasts many years and is continued even during pregnancy and breastfeeding.…”

Section: Anticoagulant Effectmentioning

confidence: 99%

Hydroxychloroquine as an important immunomodulator: a novel insight into an old drug

Pawlak-Buś,

Leszczyński

2024

Polish Archives of Internal Medicine

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Hydroxychloroquine as immune system modulator 1 continued to search for equally effective treatments without adverse effects. 1,2 Chloroquine was the first artificially synthesized quinine analogue used as an antimalarial drug. However, it also showed an adverse safety profile. Toxic effects included cutaneous and intestinal complications, cardiac damage, retinopathy, and myelopathy. More advanced forms of antimalarial drugs, mepacrine and hydroxychloroquine (HCQ), were not used until the 20th century. 3 During World War II, millions of soldiers took chloroquine and HCQ as part of a program testing the synthetic derivatives of 4 -aminoquinolines for the prevention of inflammatory cutaneous lesions and arthritis. This led to research confirming the effectiveness of antimalarial drugs in the treatment of systemic lupus erythematosus (SLE).In 1955, HCQ was approved for use in the United States. This synthetic form of quinine lacked Introduction Antimalarial drugs are currently being rediscovered and increasingly appreciated for their properties. Historically, they have been known for about 400 years, and the first antimalarial drug was quinine, an alkaloid produced from the bark of the Cinchona tree in South America. Quinine was originally used as a drug that inhibited proper cell functioning by forming a complex with DNA of the malaria -causing parasite Plasmodium falciparum. It also had additional antipyretic and analgesic effects, which was particularly important in medicine at that time. The use of quinine for an indication other than malaria was first described by Payne in 1894, when he reported successful treatment of cutaneous lupus manifestations. As an antiprotozoal drug, quinine carried the risk of complications, especially neurotoxic ones, such as vision and hearing disorders. Therefore, investigators

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“…Psychotic symptoms including auditory and visual hallucinations occur as a result of psychological symptoms that are present in most diffuse cases and individuals with localised NPSLEs showed a significant frequency of immunological disorders together with cerebral vascular disease [15,16].Generally, approximately one-third of the neuropsychiatry cases were induced directly by SLE. Furthermore, it is still unclear whether the psychiatric manifestations should be considered as a display of CNS lupus or a specific psychological occurrence of mental illness [17][18][19]. Therefore, in this study, we aimed to describe the characteristics of patients presenting with NPSLE in Dr. Sardjito General Hospital between January 2017 to January 2021.…”

Section: Introductionsmentioning

confidence: 99%

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

Tri Wirasto,

Winengku Basuki Adi

2024

JPS

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Introductions: Systemic lupus erythematosus (SLE) is one of the diseases that affects the system organs. Neuropsychiatric SLE (NPSLE) refers to the display of SLE involving both neurologic and psychiatric conditions. Methods: This retrospective study used inpatient and outpatient data from patients diagnosed with unspecified SLE and also included psychiatric manifestations between 2017 and 2021. Results: The patients’ age range was from under 10 to over 70 years old, and the average age was 31.49 years old. The highest percentage was between 31 and 40 years old, which was 27%. Out of 100 patients, 61 received the majority of their care from the internist. The highest percentage of psychiatric disorders was unspecified depressive disorder, with 17%. The second-largest proportion was other specified neurotic disorders, which was 11%. Additionally, 10% of the patients experienced a mild cognitive illness. Based on gender, women had a higher proportion compared to men. Conclusions: Our study showed that there were 100 NPSLE cases over five years, and the highest percentages were depressive disorder, neurotic symptoms, and mild cognitive disorder.

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Neuropsychiatric manifestations and their attribution to SLE: a retrospective single-center study in the Polish population

Cited by 4 publications

References 34 publications

Multidisciplinary re-evaluation of neuropsychiatric events to confirm the neuropsychiatric lupus diagnosis at an Indonesian tertiary hospital

Multidisciplinary re-evaluation of neuropsychiatric events to confirm the neuropsychiatric lupus diagnosis at an Indonesian tertiary hospital

Hydroxychloroquine as an important immunomodulator: a novel insight into an old drug

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

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