Jiang Wei, Peng Xin, Dong Liqun, Wu Ling, Di Yazhen, Lin Li
Department of Pediatric Rheumatology and Immunology, Women's and Children's Hospital of Ningbo University, Ningbo City, Zhejiang Province, China.
Division of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
PLoS One. 2025 Jun 10;20(6):e0325915. doi: 10.1371/journal.pone.0325915. eCollection 2025.
Early detection of neuropsychiatric systemic lupus erythematosus (NPSLE) in children remains challenging in clinical settings. This study aims to describe the autoantibodies, organ disorders, the SLEDAI-2K score, and complement levels at the time of diagnosis in systemic lupus erythematosus (SLE) as well as investigate the predictors of NPSLE. We reviewed medical records of hospitalized children with SLE (< 18 years old) and extracted information on clinical features, serum autoantibodies, and laboratory test results. Multivariable logistic regression was used to establish the predictors of NPSLE and SLE without neuropsychiatric manifestations. Results revealed that 22.8% of children with NPSLE had higher ANA levels and SLEDAI-2K scores, lower C4 levels, and greater AMA-M2, β2GPI Abs, Anti-Rib-P Ab, ANCA, and LAC positivity at SLE diagnosis. The predictors of NPSLE were β2GPI-Abs (OR = 4.603), anti-Rib-P Ab (OR = 4.153), and SLEDAI-2K score (OR = 1.215). In summary, the findings show that the SLEDAI-2K score, β2GPI-Abs, and anti-Rib-P Ab are predictors of NPSLE.
在临床环境中，儿童神经精神性系统性红斑狼疮（NPSLE）的早期检测仍然具有挑战性。本研究旨在描述系统性红斑狼疮（SLE）诊断时的自身抗体、器官病变、SLEDAI-2K评分和补体水平，并调查NPSLE的预测因素。我们回顾了住院的SLE患儿（<18岁）的病历，并提取了临床特征、血清自身抗体和实验室检查结果等信息。采用多变量逻辑回归来确定NPSLE和无神经精神表现的SLE的预测因素。结果显示，22.8%的NPSLE患儿在SLE诊断时ANA水平和SLEDAI-2K评分较高，C4水平较低，AMA-M2、β2GPI抗体、抗核糖体P蛋白抗体、ANCA和狼疮抗凝物阳性率较高。NPSLE的预测因素为β2GPI抗体（OR = 4.603）、抗核糖体P蛋白抗体（OR = 4.153）和SLEDAI-2K评分（OR = 1.215）。总之，研究结果表明，SLEDAI-2K评分、β2GPI抗体和抗核糖体P蛋白抗体是NPSLE的预测因素。
