Audemard-Verger Alexandra, Comby Elizabeth, Nathou Clément, Sultan Audrey, Frémont Mathieu, Baldolli Aurélie, Trumier Louis Simon, Marzloff Vincent, Le Mauff Brigitte, Manuzak Jennifer, Dollfus Sonia, Bienvenu Boris
Departement of internal medicine, CHU de Caen, France Caen University, Caen, France Immunology departement, Caen , France Department of Psychiatry, CHU de Caen, Caen Department of Immunology, Institut Cochin, Paris, France.
Medicine (Baltimore). 2016 Nov;95(47):e5288. doi: 10.1097/MD.0000000000005288.
On the basis that diagnosis of neuropsychiatric systemic lupus erythematosus (NPSLE) is sometimes difficult and systemic lupus erythematosus (SLE) can present with isolated psychiatric symptoms, we initiated a survey in a psychiatric department to screen for NPSLE in young female inpatients.We prospectively studied consecutive young female patients referred to the department of psychiatry. Antinuclear antibodies (ANA), anti-deoxyribonucleic acid (DNA), and antiextractable soluble nuclear antigens (ENA) in the serum of patients were screened. In case of positive anti-DNA or anti-ENA, the patient was referred to the department of internal medicine.One hundred patients were enrolled, mean age 33.1 ± 8.4 years. Most patients presented underlying psychiatric disorders: depression (46%), schizophrenia (13%), anxiety disorder (6%), and personality disorder (10%). A quarter of the cohort did not display underlying psychiatric disorders before hospitalization. Positive ANA ≥1:160 were found in 32 of the 100 patients tested (32%). No patients presented anti-DNA antibodies. One patient had positive anti-sjogrën's syndrome related antigen A (SSA), but did not present any features of SLE or Sjögren syndrome.Thus, systematic screening of SLE is not relevant in young women hospitalized in psychiatric department. However, clinicians should keep in mind that SLE can present with pure psychiatric symptoms.
鉴于神经精神性系统性红斑狼疮（NPSLE）的诊断有时较为困难，且系统性红斑狼疮（SLE）可能仅表现为孤立的精神症状，我们在精神科开展了一项调查，以筛查年轻女性住院患者中的NPSLE。我们对连续转诊至精神科的年轻女性患者进行了前瞻性研究。对患者血清中的抗核抗体（ANA）、抗脱氧核糖核酸（DNA）和抗可提取可溶性核抗原（ENA）进行了筛查。若抗DNA或抗ENA呈阳性，则将患者转诊至内科。共纳入100例患者，平均年龄33.1±8.4岁。大多数患者存在潜在的精神障碍：抑郁症（46%）、精神分裂症（13%）、焦虑症（6%）和人格障碍（10%）。四分之一的队列在住院前未表现出潜在的精神障碍。在100例接受检测的患者中，32例（32%）ANA≥阳性率为1:160。未发现患者有抗DNA抗体。1例患者抗干燥综合征相关抗原A（SSA）呈阳性，但未表现出SLE或干燥综合征的任何特征。因此，在精神科住院的年轻女性中进行系统性SLE筛查并无必要。然而，临床医生应牢记SLE可能仅表现为单纯的精神症状。
