Lymphopenia is associated with neuropsychiatric manifestations and disease activity in paediatric systemic lupus erythematosus patients
Journal
Rheumatology
Journal Volume
46
Journal Issue
9
Pages
1492-1494
Date Issued
2007
Author(s)
Abstract
Objectives. To investigate if lymphopenia is associated with clinical manifestations, disease activity and prognosis in systemic lupus erythematosus (SLE). Methods. The charts of 186 paediatric patients with SLE diagnosed between 1985 and 2006 in a medical centre were retrospectively reviewed. Lymphocyte counts were recorded at the time of SLE diagnosis and SLE flares. Global disease activity was quantified by the SLE Disease Activity Index (SLEDAI). Cumulative organ damage was assessed by the ACR/Systemic Lupus International Collaborating Clinics (SLICC) damage index. Results. Lymphopenia (<1500/mm3) and marked lymphopenia (<500/mm3) was observed in 62.8 and 12.2% at the time of SLE diagnosis. At the time of SLE diagnosis, lymphopenia was significantly associated with oral ulcers, leucopenia, anti-dsDNA antibodies and C4 decrease. At the time of flares, lymphopenia was significantly associated with anti-dsDNA antibodies, methylprednisolone pulse therapy, disease activity and organ damage. Using multivariate logistic regression, marked lymphopenia was independently associated with neuropsychiatric manifestations [odds ratio (OR) 7.41, 95% confidence interval (CI) 1.99-27.0], and protective from LN (OR 0.13, 95% CI 0.03-0.53). Conclusions. Lymphopenia at SLE flares is associated with disease activity and organ damage. Marked lymphopenia is independently associated with neuropsychiatric manifestations. ? The Author 2007. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
SDGs
Other Subjects
azathioprine; complement component C4; cyclophosphamide; cyclosporin; double stranded DNA antibody; hydroxychloroquine; immunoglobulin; methylprednisolone; adolescent; antibody detection; article; child; clinical feature; confidence interval; correlation analysis; corticosteroid therapy; disease activity; disease association; disease exacerbation; disease severity; drug pulse therapy; female; human; hypocomplementemia; leukopenia; lupus erythematosus nephritis; lymphocyte count; lymphocytopenia; major clinical study; male; mental disease; mouth ulcer; multivariate logistic regression analysis; neuropsychiatry; priority journal; prognosis; quantitative analysis; retrospective study; systemic lupus erythematosus; Adolescent; Antibodies, Antinuclear; Child; Child, Preschool; DNA; Female; Humans; Lupus Erythematosus, Systemic; Lupus Vasculitis, Central Nervous System; Lymphopenia; Male; Retrospective Studies; Risk Factors; Severity of Illness Index
Type
journal article