Neuropsychiatric manifestations in pediatric systemic lupus erythematosus: A 20-year study
Journal
Lupus
Journal Volume
15
Journal Issue
10
Pages
651-657
Date Issued
2006
Abstract
The objective of this study was to investigate the manifestations, treatment and outcome of neuropsychiatric (NP) involvement in pediatric systemic lupus erythematosus (SLE) patients. The charts of 185 pediatric patients with SLE diagnosed between 1985 and 2005 in a tertiary referral hospital were retrospectively reviewed. NPSLE were defined using the American College of Rheumatology NPSLE case definitions. NPSLE developed in 34.6% (64/185) of the patients. The mean onset age was 15.2 years. Fourteen patients (21.9%) had NP manifestations on initial diagnosis of SLE. The median duration from the onset of SLE to NP manifestation was 11 months. The most frequent NP manifestations were seizure disorder (84.4%), ischemic stroke (28.1%) and psychosis (21.9%). However, the prevalence of manifestations of NPSLE might be underestimated by the retrospective design of our study. Higher mean C3/C4 levels, less percentage of anti-dsDNA antibodies elevation and higher percentage of elevated anticardiolipin antibodies were observed in NPSLE events than in non-NPSLE events (P < 0.05). The mortality rate of NPSLE patients decreased from 52.2% in 1985-1994 cohort to 27.8% in 1995-2005 cohort. In the past 10 years, the leading cause of death in NPSLE patients was NPSLE itself. NPSLE is common in pediatric SLE patients. It has diverse manifestations and a high mortality. ? 2006 SAGE Publications.
SDGs
Other Subjects
antimalarial agent; azathioprine; cardiolipin antibody; corticosteroid; cyclophosphamide; cyclosporin; DNA antibody; hydroxychloroquine; immunoglobulin; methylprednisolone; mycophenolic acid 2 morpholinoethyl ester; nonsteroid antiinflammatory agent; salazosulfapyridine; adolescent; adult; article; brain hemorrhage; cerebrovascular accident; child; clinical feature; controlled study; diagnostic test; disease duration; drug dose regimen; female; human; major clinical study; male; mental disease; neuropsychiatry; physician; priority journal; psychosis; seizure; systemic lupus erythematosus; tertiary health care; treatment outcome; Adolescent; Age Distribution; Age of Onset; Child; Child, Preschool; Cohort Studies; Female; Follow-Up Studies; Humans; Lupus Erythematosus, Systemic; Lupus Vasculitis, Central Nervous System; Male; Retrospective Studies
Type
journal article