Neuropsychiatric manifestations in systemic lupus erythematosus : correlation with neuropsychiatric damage and disease activity

Abstract EN

Background Estimates of the prevalence of neuropsychiatric manifestations in systemic lupus erythematosis (SLE) range from 14 to over 80% in adults.

The clinical manifestations of nervous system involvement in SLE are highly diverse, and their etiology is incompletely understood.

Aim of the study The aim of this study was to evaluate the prevalence of neuropsychiatric manifestations in SLE and to correlate the neuropsychiatric damage with the various disease parameters.

Patients and methods A total of 100 SLE patients (48 with neuropsychiatric manifestations and 52 without) were subjected to routine laboratory testing and immunological profiling.

Systemic Lupus Activity Measure scores were estimated for assessment of disease activity.

Assessment of organ damage was carried out according to the Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index.

The neuropsychiatric damage was measured with the corresponding domain of the SDI.

The cognitive function was assessed, and MRI and electroencephalography were performed when clinically indicated.

Results A total of 48% of patients had neuropsychiatric manifestations, of which headache was the most frequent (52%), followed by cognitive deficit (50%), seizures (25%), and cerebrovascular events (25%).

On comparing between SLE patients with and without neuropsychiatric manifestations, it was revealed that there was a statistically significant difference between both groups as regards the presence of antiphospholipid (aPL) antibodies (Po0.001), fever, arthritis, and anti-Ro/SSA (Po0.05).

The neuropsychiatric damage had a significant positive correlation with the presence of aPL antibodies (r =0.69, Po0.001), presence of anti-Ro/SSA (r = 0.42, Po0.05), disease duration (r =0.38, Po0.05), and disease activity (r = 0.41, Po0.05).

Conclusion Neuropsychiatric manifestations in SLE are common; the most prevalent are headache, cognitive deficit, seizures, and cerebrovascular events.

Neuropsychiatric damage in SLE patients correlates significantly with the presence of aPL and anti-Ro/SSA antibodies, disease duration, and disease activity.