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青少年系统性红斑狼疮相关的神经精神表现:聚焦早期诊断的综述

Neuropsychiatric manifestations associated with Juvenile Systemic Lupus Erythematosus: An overview focusing on early diagnosis.

作者信息

Nikolaidou Anna, Beis Ioannis, Dragoumi Pinelopi, Zafeiriou Dimitrios

机构信息

Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

Brain Dev. 2024 Mar;46(3):125-134. doi: 10.1016/j.braindev.2023.11.008. Epub 2023 Dec 7.

Abstract

Juvenile systemic lupus erythematosus (jSLE) is a chronic multisystem inflammatory disease that manifests before the age of 16 years, following a remitting - relapsing course. The clinical presentation in children is multifaceted, most commonly including constitutional, hematological, cutaneous, renal, and neuropsychiatric symptoms. Neuropsychiatric manifestations range widely, affecting approximately 14-95 % of jSLE patients. They are associated with high morbidity and mortality, particularly at a younger age. Headaches, seizures, cognitive dysfunction, and mood disorders are the most frequent neuropsychiatric manifestations. The pathophysiological mechanism is quite complex and has not yet been fully investigated, with autoantibodies being the focus of research. The diagnosis of neuropsychiatric jSLE remains challenging and exclusionary. In this article we review the clinical neuropsychiatric manifestations associated with jSLE with the aim that early diagnosis and prompt treatment is achieved in children and adolescents with the disease.

摘要

青少年系统性红斑狼疮(jSLE)是一种慢性多系统炎症性疾病,发病于16岁之前,呈缓解-复发病程。儿童的临床表现具有多面性,最常见的包括全身症状、血液学症状、皮肤症状、肾脏症状和神经精神症状。神经精神表现范围广泛,约14%-95%的jSLE患者会受到影响。它们与高发病率和死亡率相关,尤其是在较年轻的年龄段。头痛、癫痫发作、认知功能障碍和情绪障碍是最常见的神经精神表现。其病理生理机制相当复杂,尚未得到充分研究,自身抗体是研究的重点。神经精神性jSLE的诊断仍然具有挑战性,需要排除其他疾病。在本文中,我们回顾了与jSLE相关的临床神经精神表现,目的是在患有该疾病的儿童和青少年中实现早期诊断和及时治疗。

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