REVIEW PAPER
Neuropsychiatric syndromes in systemic lupus erythematosus patients
Online publication date: 2012-12-21
Reumatologia 2012;50(6):493-500
KEYWORDS
ABSTRACT
Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease, which leads to the damage of multiple tissues and organs, including the central and peripheral nervous system. Due to the variety of neurological and psychiatric symptoms of lupus in 1999 the American College of Rheumatology (ACR) distinguished 19 neuropsychiatric syndromes that may appear in SLE and set specific criteria to diagnose them (Table I). The involvement of the nervous system in SLE occurs relatively often and neuropsychiatric syndromes correlate with severe disease progression and contribute to worse prognosis. This article presents the central nervous system (CNS) syndromes met in SLE included in the 1999 ACR classification. The latest European League Against Rheumatism (EULAR) recommendations for diagnosis and management of neuropsychiatric lupus are also presented.
REFERENCES (38)
1.
Danchenko N, Satia JA, Anthony MS. Epidemiology of systemic lupus erythematosus: a comparison of worldwide disease burden. Lupus 2006; 15: 308-318.
2.
Popescu A, Kao AH. Neuropsychiatric systemic lupus erythematosus. Curr Neuropharmacol 2011; 9: 449-457.
3.
Hanly JG, Urowitz MB, Su L, et al. Systemic Lupus International Collaborating Clinics (SLICC). Prospective analysis of neuropsychiatric events in an international disease inception cohort of patients with systemic lupus erythematosus. Ann Rheum Dis 2010; 69: 529-535.
4.
Bertsias GK, Ioannidis JP, Aringer M, et al. EULAR recommendations for the management of systemic lupus erythematosus with neuropsychiatric manifestations: Report of a task force of the EULAR standing committee for clinical affairs. Ann Rheum Dis 2010; 69: 2074-2082.
5.
Wang M, Gladman DD, Ibańez D, Urowitz MB. Long-term outcome of early neuropsychiatric events due to active disease in systemic lupus erythematosus. Arthritis Care Res 2012; 64: 833-837.
6.
Chiewthanakul P, Sawanyawisuth K, Foocharoen C, Tiamkao S. Clinical features and predictive factors in neuropsychiatric lupus. Asian Pac J Allergy Immunol 2012; 30: 55-60.
7.
Jönsen A, Bengtsson AA, Nived O, et al. Outcome of neuropsychiatric systemic lupus erythematosus within a defined Swedish population: increased morbidity but low mortality. Rheumato-logy 2002; 41: 1308-1312.
8.
ACR ad hoc committee on neuropsychiatric lupus nomenclature. The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum 1999; 42: 599-608.
9.
Rhiannon JJ. Systemic lupus erythematosus involving the nervous system: presentation, pathogenesis, and management. Clin Rev Allergy Immunol 2008; 34: 356-360. .
10.
George-Chandy A, Trysberg E, Eriksson K. Raised intrathecal levels of APRIL and BAFF in patients with systemic lupus erythematosus: relationship to neuropsychiatric symptoms. Arthritis Res Ther 2008; 10: R97.
11.
Horai Y, Watanabe H, Miyamura T, et al. Clinical analysis of cerebrospinal fluid interleukin-6 in neuropsychiatric systemic lupus erythematosus. Fukuoka Igaku Zasshi 2010; 101: 34-40.
12.
Trysberg E, Blennow K, Zachrisson O, Tarkowski A. Intrathecal levels of matrix metalloproteinases in systemic lupus erythematosus with central nervous system engagement. Arthritis Res Ther 2004; 6: R551-556.
13.
Kwieciński J, Kłak M, Trysberg E, et al. Relationship between elevated cerebrospinal fluid levels of plasminogen activator inhibitor 1 and neuronal destruction in patients with neuropsychiatric systemic lupus erythematosus. Arthritis Rheum 2009; 60: 2094-2101.
14.
Hanly JG, Urowitz MB, Su L, et al. Autoantibodies as biomarkers for the prediction of neuropsychiatric events in systemic lupus erythematosus. Ann Rheum Dis 2011; 70: 1726-1732.
16.
Zeller CB, Appenzeller S. Cardiovascular disease in systemic lupus erythematosus: the role of traditional and lupus related risk factors. Curr Cardiol Rev 2008; 4: 116-122.
17.
Mitsias P, Levine SR. Large cerebral vessel occlusive disease in systemic lupus erythematosus. Neurology 1994; 44: 385-393.
19.
Barile-Fabris L, Ariza-Andraca R, Olguín-Ortega L, et al. Controlled clinical trial of IV cyclophosphamide versus IV methylprednisolone in severe neurological manifestations in systemic lupus erythematosus. Ann Rheum Dis 2005; 64: 620-625.
20.
Orzechowski NM, Wolanskyj AP, Ahlskog JE, et al. Antiphospholipid antibody-associated chorea. J Rheumatol 2008; 35: 2165-2170.
21.
Ferreira S, D’Cruz DP, Hughes GRV. Multiple sclerosis, neuropsychiatric lupus and antiphospholipid syndrome: where do we stand? Rheumatology 2005; 44: 434-443.
22.
Bobrowska-Snarska D, Ostanek L, Brzosko M. Pląsawica jako pierwszy, rzadko występujący objaw tocznia rumieniowatego układowego u osób w podeszłym wieku. Pol Arch Med Wewn 2008; 118; Suppl: 75-79.
23.
Chau SY, Mok CC. Factors predictive of corticosteroid psychosis in patients with systemic lupus erythematosus. Neurology 2003; 61: 104-107.
24.
Greco CM, Rudy TE, Manzi S. Effects of a stress-reduction program on psychological function, pain, and physical function of systemic lupus erythematosus patients: a randomized controlled trial. Arthritis Rheum 2004; 51: 625-34.
25.
Nowicka-Sauer K, Czuszyńska Z, Smoleńska Ż, et al. Neuropsychological assessment in systemic lupus erythematosus patients: clinical usefulness of first-choice diagnostic tests in detecting cognitive impairment and preliminary diagnosis of neuropsychiatric lupus. Clin Exp Rheumatol 2011; 29: 299-306.
26.
Tomietto P, Annese V, D’Agostini S, et al. General and specific factors associated with severity of cognitive impairment in systemic lupus erythematosus. Arthritis Rheum 2007; 57: 1461-1472.
27.
Hanly JG, Cassell K, Fisk JD. Cognitive function in systemic lupus erythematosus: Results of a 5-year prospective study. Arthritis Rheum 1997; 40: 1542-1543.
28.
Harrison MJ, Morris KA, Horton R, et al. Results of intervention for lupus patients with self-perceived cognitive difficulties. Neurology 2005; 65: 1325-1327.
29.
Kaplin AI, Krishnan C, Deshpande DM, et al. Diagnosis and management of acute myelopathies. Neurologist 2005; 11: 2-18.
30.
Espinosa G, Mendizábal A, Mínguez S, et al. Transverse myelitis affecting more than 4 spinal segments associated with systemic lupus erythematosus: clinical, immunological, and radiological characteristics of 22 patients. Semin Arthritis Rheum 2010; 39: 246-256.
31.
Birnbaum J, Petri M, Thompson R, et al. Distinct subtypes of myelitis in systemic lupus erythematosus. Arthritis Rheum 2009; 60: 3378-3387.
32.
Pittock SJ, Lennon VA, de Seze J, et al. Neuromyelitis optica and non organ-specific autoimmunity. Arch Neurol 2008; 65: 78-83.
33.
Kim JM, Kim KJ, Yoon HS, et al. Meningitis in Korean patients with systemic lupus erythematosus: analysis of demographics, clinical features and outcomes; experience from affiliated hospitals of the Catholic University of Korea. Lupus 2011; 20: 531-536.
34.
Baizabal-Carvallo JF, Delgadillo-Márquez G, Estańol B, García-Ramos G. Clinical characteristics and outcomes of the meningitides in systemic lupus erythematosus. Eur Neurol 2009; 61: 143-148.
35.
Horizon AA, Wallace DJ. Risk:benefit ratio of nonsteroidal anti-inflammatory drugs in systemic lupus erythematosus. Expert Opin Drug Saf 2004; 3: 273-278.
36.
Fulford KW, Catterall RD, Delhanty JJ, et al. A collagen disorder of the nervous system presenting as multiple sclerosis. Brain 1972; 95: 373-386. .
37.
Ellis SG, Verity MA. Central nervous system involvement in systemic lupus erythematosus: a review of neuropathologic findings in 57 cases, 1955-1977. Semin Arthritis Rheum 1979; 8: 212-221.
38.
Szmyrka-Kaczmarek M, Pokryszko-Dragan A, Pawlik B, et al. Antinuclear and antiphospholipid antibodies in patients with multiple sclerosis. Lupus 2012; 21: 412-420.
Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Share
RELATED ARTICLE
| eISSN: | 2084-9834 |
| ISSN: | 0034-6233 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
