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.

Adult systemic lupus erythematosus in Egypt: The nation-wide spectrum of 3661 patients and world-wide standpoint

Lupus ◽  
2021 ◽  
pp. 096120332110142
Author(s):  
Tamer A Gheita ◽  
Rasha Abdel Noor ◽  
Esam Abualfadl ◽  
Osama S Abousehly ◽  
Iman I El-Gazzar ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Age Of Onset ◽  
Wide Spectrum ◽  
Age At Onset ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Population Based ◽  
Systemic Lupus ◽  
Cross Sectional

Objective The aim of this study was to present the epidemiology, clinical manifestations and treatment pattern of systemic lupus erythematosus (SLE) in Egyptian patients over the country and compare the findings to large cohorts worldwide. Objectives were extended to focus on the age at onset and gender driven influence on the disease characteristics. Patients and method This population-based, multicenter, cross-sectional study included 3661 adult SLE patients from Egyptian rheumatology departments across the nation. Demographic, clinical, and therapeutic data were assessed for all patients. Results The study included 3661 patients; 3296 females and 365 males (9.03:1) and the median age was 30 years (17–79 years), disease duration 4 years (0–75 years) while the median age at disease onset was 25 years (4–75 years). The overall estimated prevalence of adult SLE in Egypt was 6.1/100,000 population (1.2/100,000 males and 11.3/100,000 females).There were 316 (8.6%) juvenile-onset (Jo-SLE) and 3345 adult-onset (Ao-SLE). Age at onset was highest in South and lowest in Cairo (p < 0.0001). Conclusion SLE in Egypt had a wide variety of clinical and immunological manifestations, with some similarities with that in other nations and differences within the same country. The clinical characteristics, autoantibodies and comorbidities are comparable between Ao-SLE and Jo-SLE. The frequency of various clinical and immunological manifestations varied between gender. Additional studies are needed to determine the underlying factors contributing to gender and age of onset differences.

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 Intestinal Microbiota and Active Systemic Lupus Erythematosus: protocol for a systematic review

2021 ◽  
Author(s):  
Juliana Rosa Pires Vieira ◽  
Andréa Toledo de Oliveira Rezende ◽  
Marcos Rassi Fernandes ◽  
Nilzio Antônio Silva
Keyword(s):  
Systematic Review ◽  
Systemic Lupus Erythematosus ◽  
Intestinal Microbiota ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Disease Activity Index ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Assessment Development ◽  
American College Of Rheumatology

Abstract BackgroundSystemic Lupus Erythematosus (SLE) is an autoimmune disease, characterized by being multi-systemic and, therefore, reaching various organs and affecting mainly young women. Its pathogenesis comprehends many factors, including the interaction between microbiota and immune system. The aim of this systematic review protocol is to assess the relationship between intestinal microbiota and SLE in activity, highlighting microbiota representative patterns regarding quantity and diversity. MethodsThe systematic review will be carried out using the following databases: Medline via PubMed, Scopus, and EMBASE. Inclusion criteria will be: observational studies (cross-sectional, cohort, and case-control) that analyzed intestinal microbiota composition in patients with SLE, with no restriction of age or sex, which fulfilled the classification criteria of either Systemic Lupus International Collaborating Clinic (SLICC), European League Against Rheumatism (EULAR) or American College of Rheumatology (ACR) and used the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) to classify disease in activity or remission. The Downs & Black Scale will be applied to analyze the risk of bias during study selection and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) will be used to assess the quality of the evidence of the selected studies.DiscussionThis review will identify investigation gaps, for better understanding of aspects related to etiopathogenesis and to the inflammatory process during SLE progression. Systematic review registration PROSPERO registration: CRD42021229322

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.

Correlation between systemic lupus erythematosus and malignancies: a cross-sectional population-based study

2017 ◽  
Vol 65 (2) ◽  
pp. 464-469 ◽  
Author(s):  
Shir Azrielant ◽  
Shmuel Tiosano ◽  
Abdulla Watad ◽  
Naim Mahroum ◽  
Aaron Whitby ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Population Based ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Population Based Study

scholarly journals Perbandingan Diagnosis Systemic Lupus Erythematosus Menggunakan Kriteria American College of Rheumatologi dan Systemic Lupus International Collaborating Clinics

Sari Pediatri ◽  
2017 ◽  
Vol 18 (4) ◽  
pp. 299
Author(s):  
Titi Pambudi Karuniawaty ◽  
Sumadiono Sumadiono ◽  
Cahya Dewi Satria
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
American College Of Rheumatology

Latar belakang. Systemic lupus erythematosus (SLE) merupakan penyakit autoimun yang melibatkan multi organ dengan spektrum klinis dan imunologis yang luas. Kriteria diagnostik SLE pertama kali diperkenalkan oleh American College of Rheumatology (ACR) pada 1971 dan telah mengalami revisi pada 1982 dan 1997. Tujuan. Membandingkan kriteria ACR dan kriteria SLICC dan menilai agreement antara kriteria SLICC dan ACR untuk menegakkan diagnosis SLE.Metode. Penelitian studi cross-sectional terhadap pasien SLE yang dirawat di bagian Anak RS Sardjito Yogyakarta antara Januari 2009-Juni 2015. Metode total sampling digunakan pada penelitian ini. Pengumpulan data dilakukan melalui rekam medis, untuk menilai masing-masing kriteria pada saat anak terdiagnosis SLE, kemudian dilakukan penilaian agreement di antara kedua kriteria tersebut.Hasil. Didapatkan 64 anak didiagnosis SLE dan 46 (71,9%) memenuhi kriteria ACR. Sebanyak 39 (60,9%) memenuhi kriteria SLICC. Penelitian ini mendapatkan overall agreement yang baik (ρ0=0,70) di antara kedua kriteria tersebut, dengan chance-corrected agreement κ=0,33, atau dinyatakan cukup.Kesimpulan. Kriteria SLICC memiliki agreement yang cukup baik dengan kriteria ACR. Kriteria SLICC dapat dipertimbangkan sebagai alternatif metode untuk menegakkan diagnosis SLE pada anak. Perlu penelitian lanjutan untuk menilai kemungkinan penerapan kriteria ini untuk menggantikan kriteria ACR yang telah dipakai secara luas sebelumnya.

scholarly journals Relationship between Interleukin 6 Serum Levels and Degree of Depression in Systemic Lupus Erythematosus Patients Internal Disease in Dr. Moh Hoesin Palembang

2021 ◽  
Vol 5 (3) ◽  
pp. 295-306
Author(s):  
Shinta Suharno ◽  
Eddy Mart Salim ◽  
Ali Apriansyah ◽  
Taufik Indrajaya ◽  
Zen Ahmad ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Serum Levels ◽  
Mild Depression ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Organ Systems ◽  
Value Range ◽  
Cross Sectional Design

Introduction. Systemic Lupus Erythematosus (LES) is a chronic autoimmune inflammatory disease affecting many organ systems with varied clinical manifestations, disease course and prognosis. One of the clinical manifestations that can occur is depression as much as 25%. In LES patients, there is an increase in proinflammatory cytokines, one of which is IL-6, which is often associated with contributing to the pathophysiology of depression. The purpose of this study was to determine the relationship between serum IL-6 levels and the degree of depression in LES patients at RSUP DR. Mohammad Hoesin Palembang. Methods. Analytic observational study in the form of correlation test with cross sectional design which was conducted in the Internal Medicine room RSUP DR. Mohammad Hoesin Palembang from May 2019 to March 2020. The number of study subjects was 40 samples who were LES patients with depression who had been calculated using the BDI (Beck's Depression Inventory). All subjects were examined for serum IL-6 levels and evaluated for factors that influence it. Results. There were 40 study subjects aged 18-56 years. The median degree of depression was 16 with a range of values from 10 to 40. There were 17 people (42.5%) with mild depression degree, 14 people (35%) moderate depression, and 9 people (22.5%) major depression. In LES activities, there were 5 people (12.5%) with light LES activities, 20 people (50%) with moderate LES activities, and 15 people (37.5%) with heavy LES activities. The mean serum IL-6 level was 11.57 pg / mL with a value range of 1.1-50pg / mL. There was a significant correlation between the degree of depression and LES activity (p = 0.004; r = 0.444) and between serum IL-6 levels and the degree of depression (p = 0.025; r = 0.169). However, there was no significant correlation between serum IL-6 levels and LES activity (p = 0.057; r = 0.304). Conclusion. There is a relationship between serum IL-6 levels and the degree of depression in LES patients at Dr. Moh. Hoesin Palembang with a very weak correlation.

scholarly journals Mortality and Cardiovascular Burden of Systemic Lupus Erythematosus in a US Population-based Cohort

2014 ◽  
Vol 41 (4) ◽  
pp. 680-687 ◽  
Author(s):  
Christie M. Bartels ◽  
Kevin A. Buhr ◽  
Jerry W. Goldberg ◽  
Carolyn L. Bell ◽  
Maja Visekruna ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Population Based ◽  
Systemic Lupus ◽  
Physician Review ◽  
American College Of Rheumatology ◽  
Population Comparisons ◽  
State Death ◽  
Chart Audits ◽  
Incident Cases

Objective.To examine the mortality and cardiovascular disease (CVD) burden among a population-based cohort of patients with systemic lupus erythematosus (SLE) with previously described late mean onset and low rates of organ-threatening disease.Methods.This retrospective population-based cohort study investigated incident cases of SLE diagnosed from 1991–2008 and followed through March 2009 to examine rates of death and CVD events: myocardial infarction, stroke, or congestive heart failure hospitalization. Cases were identified using the 1997 update of the 1982 American College of Rheumatology SLE criteria. Searches included electronic records, chart audits, and state death matches, with physician review. Age-matched and sex-matched population comparisons facilitated relative event rate calculations.Results.Seventy incident SLE cases had late mean onset (52 years), with an incidence of 5 cases per 100,000/year. Matched comparisons showed similar baseline rates of hypertension, hyperlipidemia, and diabetes. However, patients with SLE experienced more CVD in the 2 years preceding SLE diagnosis (OR 3.8, 95% CI 1.8, 8.0). The estimated 10-year mortality rates were 26% for SLE subjects versus 19% for comparisons, hazard ratio (HR) 2.1, p < 0.01. Adjusted for prior CVD, SLE cases still demonstrated increased hazards of mortality (HR 1.9, p = 0.01) and CVD event or death (HR 1.8, p = 0.01).Conclusion.This incident SLE cohort demonstrated nearly doubled mortality and CVD event hazards compared to age-matched and sex-matched comparisons, even after accounting for higher CVD events in the 2 years preceding SLE diagnosis. This raises research questions regarding delayed SLE diagnosis versus accelerated CVD prior to SLE, particularly in older-onset SLE.

scholarly journals The Differences in Serum Complements and Anti-dsDNA Levels between Renal and Non-renal Manifestations in Systemic Lupus Erythematosus

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Bagus Putu Putra Suryana ◽  
Lya Rosita ◽  
Nursamsu Djais ◽  
Dian Hasanah
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Complement C3 ◽  
Sectional Study ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
American College Of Rheumatology ◽  
Renal Manifestation

Background. Systemic lupus erythematosus (SLE) has diverse clinical manifestations, including renal and non-renal. Renal manifestation is related to significant morbidity and mortality. SLE is also characterized by serological aberrations, including levels of complement C3, C4 and anti-dsDNA, but the association of them with clinical manifestations including renal and non-renal is unclear. This study investigated the associations of C3, C4 and anti-dsDNA levels with renal and non-renal manifestations in SLE patients. Method. A cross-sectional study was conducted in the Polyclinic of Rheumatology, Dr. Saiful Anwar Hospital Malang. A number of 43 subjects fulfilled the 1997 American College of Rheumatology criteria participated in this study, that consisted of 11 patients with renal manifestation and 32 patients with non-renal manifestations. Serum C3 and C4 levels were measured using immunoturbidimetry, and serum anti-dsDNA levels were measured using enzyme-linked immunosorbent assays (ELISA). The independent T-test was used to compare C3 levels and the Mann-Whitney U test was used to compare C4 and anti-dsDNA levels between groups. Result. SLE with renal manifestation had significant lower levels of serum C3 compare to non-renal manifestations (mean ± SD: 71.27 ± 32.65 mg/dL and 94.47 ± 26.29 mg/dL respectively, p=0.022). SLE with renal manifestation also had significantly lower levels of  serum C4 compare to non-renal manifestations (mean ± SD: 14.55 ± 8.20 mg/dL and 25.50 ± 11.05 mg/dL respectively, p=0.002). Conversely, SLE with renal manifestation had significantly higher levels of serum anti-dsDNA compare to non-renal manifestations (mean ± SD: 249.27 ± 240.34 IU/mL and 109.91 ± 166.11 IU/mL respectively, p=0.014). Conclusion. SLE patients with renal manifestation have significantly lower levels of serum C3 and C4 and a higher level of serum anti-dsDNA than SLE patients with non-renal manifestations.

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