RESEARCH - Neuropsychiatric events at the time of diagnosis of SLE

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Arthritis Rheum. 2006 Dec 28;56(1):265-273 [Epub ahead of print]

Neuropsychiatric events at the time of diagnosis of systemic lupus

erythematosus: An international inception cohort study.

Queen II Health Sciences Centre, and Dalhousie University,

Halifax, Nova Scotia, Canada.

OBJECTIVE: To describe the prevalence, characteristics, attribution, and

clinical significance of neuropsychiatric (NP) events in an international

inception cohort of systemic lupus erythematosus (SLE) patients. METHODS:

The study was conducted by the Systemic Lupus International Collaborating

Clinics (SLICC). Patients were enrolled within 15 months of fulfilling the

American College of Rheumatology (ACR) SLE classification criteria. All NP

events within a predefined enrollment window were identified using the ACR

case definitions of 19 NP syndromes. Decision rules were derived to

determine the proportion of NP disease attributable to SLE. Clinical

significance was determined using the Short Form 36 (SF-36) Health Survey

and the SLICC/ACR Damage Index (SDI). RESULTS: A total of 572 patients (88%

female) were recruited, with a mean +/- SD age of 35 +/- 14 years. The mean

+/- SD disease duration was 5.2 +/- 4.2 months. Within the enrollment

window, 158 of 572 patients (28%) had at least 1 NP event. In total, there

were 242 NP events that encompassed 15 of 19 NP syndromes. The proportion of

NP events attributed to SLE varied from 19% to 38% using alternate

attribution models and occurred in 6.1-11.7% of patients. Those with NP

events, regardless of attribution, had lower scores on the SF-36 and higher

SDI scores compared with patients with no NP events.

CONCLUSION: Twenty-eight percent of SLE patients experienced at least 1 NP

event around the time of diagnosis of SLE, of which only a minority were

attributed to SLE. Regardless of attribution, the occurrence of NP events

was associated with reduced quality of life and increased organ damage.

PMID: 17195230

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

7195230

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