scholarly journals Pattern and prevalence of neuropsychiatric lupus: a retrospective study from a tertiary level hospital in Bangladesh

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Fahima Hossain ◽  
Mohammad Delwer Hossain Hawlader ◽  
Dipak Kumar Mitra ◽  
Mohammad Hayatun Nabi ◽  
Md. Mujibur Rahman
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Retrospective Study ◽  
Cognitive Dysfunction ◽  
Lupus Erythematosus ◽  
Neuropsychiatric Symptoms ◽  
Tertiary Care ◽  
Care Hospital ◽  
Systemic Lupus ◽  
Case Definitions ◽  
American College Of Rheumatology

Abstract Background Neuropsychiatric systemic lupus erythematosus (NPSLE) is well known for its varying presentations and poor outcomes, but little is evident about its distribution and characteristics among the Bangladeshi population. This study aimed to assess the pattern and prevalence of neuropsychiatric symptoms in female systemic lupus erythematosus (SLE) patients of Bangladesh. A retrospective study was conducted at a tertiary care hospital in Dhaka, Bangladesh, between January and December 2018. One hundred female SLE patients were included in the study purposively. Data were collected on sociodemographic and clinical characteristics of diagnosed SLE cases visiting the SLE clinic and indoor medicine department. Neuropsychiatric (NP) syndromes were defined according to the widely accepted American College of Rheumatology (ACR) nomenclature and case definitions. Results A total of 244 NP events were identified in fifty-five patients. Headache was the most frequent symptom (55%), followed by cognitive dysfunction (50%), anxiety (49%), psychosis (43%), seizure (23%), depression (17%), and cerebrovascular disease (ischemic type, 7%). The NP manifestations were more prevalent among urban residents (58.2%), younger patients (41.8%), and patients with graduate-level education (34.5%). Besides, young age at diagnosis (p = 0.038), Raynaud’s phenomenon (p = 0.015), other organ involvement (p < 0.001), and time of NPSLE development (p < 0.001) were found to be significantly associated with the development of these manifestations. Conclusion NP damage is prevalent among Bangladeshi female SLE patients (55%) with headache and cognitive dysfunction being the most common symptoms. Routine screening for neuropsychiatric symptoms among suspected SLE cases and further evaluation with a larger population are warranted.

scholarly journals A retrospective study of systemic manifestations in systemic lupus erythematosus in a tertiary care centre

2019 ◽  
Vol 5 (1) ◽  
pp. 175
Author(s):  
Deepmala Budhrani ◽  
Pooja Raja ◽  
Monal Jadwani ◽  
Khushbu Chauhan ◽  
Bharti Patel ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Retrospective Study ◽  
Lupus Erythematosus ◽  
Tertiary Care ◽  
Care Hospital ◽  
Systemic Lupus ◽  
Case Record ◽  
Systemic Involvement ◽  
Function Test ◽  
Systemic Manifestations

<p class="abstract"><strong>Background:</strong> Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organ systems. Other than cutaneous manifestations, thorough examination and investigations for systemic involvement should also be done. The objective is to study the prevalence of various systemic manifestations in SLE patients in a tertiary care hospital.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was conducted from April 2009 to August 2018 on the patients who fulfilled the Systemic Lupus International Collaborating Clinics (SLICC) criteria for SLE. A total of 63 cases of SLE were extracted from the case record for the study. Each case was subjected to detailed history, examination, investigations including complete blood count, liver function test, renal function test, blood sugar, urine routine examination, ECG, X-ray of chest and involved joints, USG abdomen, pulmonary function test. Ours being a resource limited set-up, ANA, ENA profile and echocardiography were done whenever patient could afford.<strong></strong></p><p class="abstract"><strong>Results:</strong> In present study of 63 cases of SLE 94% were females. Mean age was 30 years. Various systemic involvement was present, amongst them musculoskeletal system was the most common system involved with 60 (95%) patients, followed by hematological system 48 (76%), renal system 37 (59%), neuropsychiatric system 29 (46%), gastrointestinal system 28 (44%), reproductive system 27 (43%), cardiovascular system 25 (40%). Other systems with ophthalmic involvement 23 (21%), hepatobiliary system 22 (35%), respiratory system 17 (27%), endocrine involvement 13 (28%) and malignanacy was present in 2 (3%) cases.</p><p class="abstract"><strong>Conclusions:</strong> SLE is protean in its manifestations. Thorough knowledge about the systemic involvement will help in tailoring the treatment in case of SLE.</p>

Assessment of Quality of Life (QoL) in Systemic Lupus Erythematosus Patients at a Tertiary Care Hospital in Egypt

2019 ◽  
Vol 15 (4) ◽  
pp. 304-311
Author(s):  
Mervat E. Behiry ◽  
Sahar A. Ahmed ◽  
Eman H. Elsebaie
Keyword(s):  
Quality Of Life ◽  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Tertiary Care ◽  
Damage Index ◽  
Life Questionnaire ◽  
Care Hospital ◽  
Systemic Lupus

: Systemic Lupus Erythematosus (SLE) has a profound impact on quality of life. Objective: The objective of this study was to explore the quality of life among Egyptian SLE patients and to assess its relationships with demographic and clinical features. Methods: One hundred sixty-four SLE patients were recruited for this study. Demographic information; clinical parameters; disease activity, as evaluated by the systemic lupus erythematosus Disease Activity Index; and organ damage, as assessed by the systemic lupus international Collaborative Clinics/American College of Rheumatology Damage Index, were reported. Quality of life was assessed with a quality of life questionnaire specifically designed for patients with systemic lupus erythematosus; the questions are grouped in the following six domains: physical function, sociooccupational activities, symptoms, treatment, mood, and self-image. Higher values indicate poorer quality of life. Conclusion: Poor quality of life among Egyptian SLE patients and disease activity are strongly related to impaired lifestyles in these patients.

scholarly journals Presentation of Childhood Systemic Lupus Erythematosus in a Tertiary Care Hospital

2015 ◽  
Vol 38 (3) ◽  
pp. 124-129
Author(s):  
Shahana A Rahman ◽  
Mohammad Imnul Islam ◽  
Manik Kumar Talukder ◽  
Mohammed Mahbubul Islam ◽  
Syed Saimul Huque ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Renal Involvement ◽  
Tertiary Care ◽  
Study Data ◽  
Care Hospital ◽  
Class Iii ◽  
Systemic Lupus ◽  
Presenting Symptoms ◽  
General Weakness

Background: Systemic lupus erythematosus in children (Paediatric SLE / pSLE) may have a great variability in disease presentation. Any organ system can be involved in pSLE leading to protean clinical manifestations.To evaluate the clinical and serological presentation of pSLE in tertiary renter Bangladesh and to compare it with other populations. Methodology: It was a retrospective cohort study carried out in the department of Paediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka during the period of January 2005 to December 2013. A total of 70 patients fulfilling the 1997 revised ACR classification criteria for SLE were enrolled in the study. Data was collected in a pre-designed questionnaire. Results: Age range was 2.5 years to 16 years, female: male ratio was 7:1. Duration of disease was 1 month to 18 months. Common clinical presentation included general weakness/fatigue (91%), fever (83%), arthralgia/arthritis (74%), oral ulcer (73%) and skin rash (71%). All the patients were anemic. ANA was positive in 97% cases and anti-ds DNA in 91% cases. More than 65% cases had evidences of renal involvement at the presentation. Among the patients who underwent kidney biopsy, 40% had diffuse proliferative lupus nephritis (WHO class IV) followed by class III in 26% cases. Conclusion: Pediatric SLE patients in our country, compared to other countries had much higher incidence of fever and non-specific complaints such as, general weakness and malaise as presenting symptoms. Thus, a strong index of suspicion should be maintained for early diagnosis of pSLE especially among adolescent girls. DOI: http://dx.doi.org/10.3329/bjch.v38i3.22819 Bangladesh J Child Health 2014; VOL 38 (3) :124-129

The prevalence of neuropsychiatric syndromes in systemic lupus erythematosus

Neurology ◽  
2001 ◽  
Vol 57 (3) ◽  
pp. 496-500 ◽  
Author(s):  
H. Ainiala ◽  
J. Loukkola ◽  
J. Peltola ◽  
M. Korpela ◽  
A. Hietaharju
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Population Based ◽  
Clinical Impression ◽  
Mild Depression ◽  
Systemic Lupus ◽  
Case Definitions ◽  
Cross Sectional ◽  
American College Of Rheumatology ◽  
Neuropsychologic Testing

Objective: To describe the prevalence of neuropsychiatric (NP) syndromes in a Finnish population of patients with systemic lupus erythematosus (SLE) and to classify them according to the recently developed American College of Rheumatology (ACR) nomenclature and case definitions for NPSLE.Methods: Cross-sectional, population-based study covering an area with 440,000 people. A total of 58 patients with a definite diagnosis of SLE and aged 16 to 65 years were found in the computerized database of the area hospitals. Of these, 46 (79%) agreed to participate. The diagnosis of various NP syndromes was based on clinical impression (H.A.) following history, examination, review of medical records, and neuropsychologic testing.Results: At least one NP syndrome was identified in 42 patients (91%). The most frequent manifestation was cognitive dysfunction (n = 37; 81%), followed by headache (n = 25; 54%) and mood disorder (n = 20; 43%). When mild NP syndromes (mild cognitive deficit, headache, mild depression, anxiety, electroneuromyography-negative polyneuropathy) were excluded, the prevalence of NPSLE dropped to 46%.Conclusions: According to the ACR nomenclature, there is a high prevalence of NP manifestations in a population-based sample of patients with SLE. Most NP syndromes were classified as minor; if they were excluded, the 46% prevalence of NPSLE would be slightly less than estimated in previous studies.

scholarly journals Frequency and predictors of pulmonary hypertension in patients with Systemic Lupus Erythematosus

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Sadia Asif ◽  
Aflak Rasheed ◽  
Tafazzul-e-Haque Mahmud ◽  
Ammad Asghar
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Pulmonary Hypertension ◽  
Rheumatoid Factor ◽  
Lupus Erythematosus ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Care Hospital ◽  
Systemic Lupus ◽  
Raynaud Phenomenon ◽  
Pulmonary Arterial

Objective: To determine the frequency and predictors of pulmonary hypertension in patients with Systemic Lupus Erythematosus in a Pakistani population, presenting at a tertiary care hospital Methods: This cross-sectional study was conducted at the Department of Rheumatology, Shiekh Zayed Hospital, Lahore from March to June 2018. A total of 97 patients, who fulfilled the Systemic Lupus Erythematosus (SLE) criteria of American College of Rheumatology (ACR) 1992 were enrolled. Pulmonary Arterial Hypertension (PAH) was measured by calculating pulmonary arterial systolic pressure through echocardiography by a single consultant cardiologist. Disease characteristics and demography was collected in a self-administered proforma. PAH was defined as mean pulmonary arterial pressure of 25mmHg or above by calculating with a formula. SPSS version 20 was used for analysis of data. Results: Out of 97 patients, 89.7% (n=87) were females and 10.3% (n=10) were males, with mean age of 31.29±8.824 years. The mean disease duration was 24.21±30.46 months. PAH was found in 23.3% (n=23) patients, including 19 females and 4 males. On further analysis of data, Raynaud phenomenon, rheumatoid factor and nephritis were assessed as predictors of PAH and all of these showed statistical significance for presence of PAH as per Chi-square test (p<0.05). Conclusion: In this study, 23.3% SLE patients showed evidence of PAH and positive statistical significance was found between predictors like Raynaud phenomenon, rheumatoid factor, nephritis and presence of PAH. So it is imperative to detect PAH early and start prompt treatment to achieve better quality of life. How to cite this:Asif S, Rasheed A, Mahmud TH, Asghar A. Frequency and predictors of pulmonary hypertension in patients with Systemic Lupus Erythematosus. Pak J Med Sci. 2019;35(1):86-89. doi: https://doi.org/10.12669/pjms.35.1.405 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Prospective Study of Neuropsychiatric Events in Systemic Lupus Erythematosus

2009 ◽  
Vol 36 (7) ◽  
pp. 1449-1459 ◽  
Author(s):  
JOHN G. HANLY ◽  
LI SU ◽  
VERN FAREWELL ◽  
GRACE McCURDY ◽  
LISA FOUGERE ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Short Form ◽  
Organ Damage ◽  
Self Report ◽  
Systemic Lupus ◽  
Case Definitions ◽  
American College Of Rheumatology ◽  
Academic Center ◽  
Over Time

Objective.To prospectively examine neuropsychiatric (NP) events and their association with health related quality of life (HRQOL) over time in patients with systemic lupus erythematosus (SLE).Methods.In an observational cohort study from a single academic center, NP events and their attribution were identified at enrollment and at annual assessments for up to 7 years. NP events were characterized using the American College of Rheumatology case definitions; other variables were global SLE disease activity and cumulative organ damage. The outcomes of NP events were recorded and self-report HRQOL was measured with the mental (MCS) and physical (PCS) component summary scores of the Medical Outcomes Study Short Form-36.Results.There were 209 patients, 88% female and 92% Caucasian, with a mean (standard deviation) age of 43.7 (13.8) years. Followup was available in 175/209 (84%) patients. There were 299 NP events in 132/209 (63%) patients over a mean followup of 3.6 (2.5) years. Thirty-one percent of NP events in 54 patients were attributed to SLE. Multivariate analysis indicated lower MCS scores in patients with NP events compared to those without events (p < 0.001) regardless of attribution. The group means for PCS scores were significantly lower in patients with NP events (p < 0.001) regardless of attribution. There was no association between HRQOL and cumulative organ damage, nor between NP events and the progression of organ damage.Conclusion.The association of lower HRQOL with NP events over time, which is independent of progression in cumulative organ damage, emphasizes the persistent negative effect of NP events in the lives of patients with SLE.

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