Department of Rheumatology, Rehabilitation and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland; Department of Rheumatology and Osteoporosis, J. Struś Municipal Hospital, Poznań, Poland.
Department of Rheumatology, Rehabilitation and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland
Pol Arch Intern Med. 2022 Nov 25;132(11). doi: 10.20452/pamw.16319. Epub 2022 Aug 18.
Neuropsychiatric (NP) manifestations occur in patients with systemic lupus erythematosus (SLE), and it is challenging to distinguish these manifestations from other neuropsychiatric conditions.
We aimed to assess the prevalence of primary neuropsychiatric SLE (NPSLE) in a Polish cohort of SLE patients.
This retrospective, cross‑sectional study evaluated 164 patients with SLE. NP manifestations were attributed to SLE using the Italian model. Demographic and clinical data, including disease activity (measured by the Systemic Lupus Erythematosus Disease Activity Index version 2000 [SLEDAI‑2K] and the Physician Global Assessment) and organ damage (measured by the Systemic Lupus International Collaborating Clinics / American College of Rheumatology Damage Index), were obtained in patients with and without NP manifestations attributed to SLE.
The final analysis set included 143 patients, 34 of whom (23.8%) had NP manifestations attributed to SLE. The age of the patients with NPSLE and the age of disease onset were significantly lower in comparison with those without NP symptoms attributed to SLE (median [interquartile range], 38 [29-45] vs 45 [32-55] years; P = 0.009, and 35 [24-38] vs 40 [25-48] years; P = 0.03, respectively). The disease activity and proportion of patients with active disease (SLEDAI‑2K ≥6) was significantly higher in the NPSLE patients than in those without NP symptoms attributed to SLE (P <0.005; 100% vs 85.3%; P = 0.01, respectively). NP manifestations in the central nervous system were the most frequent (91.5%). In the patients with NPSLE, cerebrovascular disease, seizures, cognitive dysfunction, psychosis, and cranial neuropathy occurred most often.
NP manifestations occurred mainly in young patients with high disease activity. Cerebrovascular disease, seizures, psychosis, cognitive dysfunction, and cranial neuropathy were the most frequent manifestations of NPSLE.
神经精神性（NP）表现发生在系统性红斑狼疮（SLE）患者中，很难将这些表现与其他神经精神性疾病区分开来。
我们旨在评估波兰 SLE 患者队列中原发性神经精神性 SLE（NPSLE）的患病率。
这项回顾性、横断面研究评估了 164 例 SLE 患者。使用意大利模型将 NP 表现归因于 SLE。在有和没有归因于 SLE 的 NP 表现的患者中，获得了人口统计学和临床数据，包括疾病活动（通过系统性红斑狼疮疾病活动指数 2000 版[SLEDAI-2K]和医生总体评估来衡量）和器官损伤（通过系统性红斑狼疮国际合作临床/美国风湿病学会损伤指数来衡量）。
最终分析集包括 143 例患者，其中 34 例（23.8%）有归因于 SLE 的 NP 表现。与没有 NP 症状归因于 SLE 的患者相比，NPSLE 患者的年龄和疾病发病年龄明显较低（中位数[四分位距]，38 [29-45] vs 45 [32-55] 岁；P = 0.009，和 35 [24-38] vs 40 [25-48] 岁；P = 0.03）。NPSLE 患者的疾病活动度和活动期患者的比例明显高于无 NP 症状归因于 SLE 的患者（P <0.005；100% vs 85.3%；P = 0.01）。中枢神经系统的 NP 表现最常见（91.5%）。在 NPSLE 患者中，最常见的表现为脑血管病、癫痫发作、认知功能障碍、精神病和颅神经病。
NP 表现主要发生在疾病活动度高的年轻患者中。脑血管病、癫痫发作、精神病、认知功能障碍和颅神经病是 NPSLE 最常见的表现。
