Neuropsychiatric involvement in juvenile-onset systemic lupus erythematosus: Data from the UK Juvenile-onset systemic lupus erythematosus cohort study



Giani, Teresa, Smith, Eve Md, Al-Abadi, Eslam, Armon, Kate, Bailey, Kathryn, Ciurtin, Coziana, Davidson, Joyce, Gardner-Medwin, Janet, Haslam, Kirsty, Hawley, Dan P
et al (show 16 more authors) (2021) Neuropsychiatric involvement in juvenile-onset systemic lupus erythematosus: Data from the UK Juvenile-onset systemic lupus erythematosus cohort study. LUPUS, 30 (12). pp. 1955-1965.

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Abstract

<h4>Introduction</h4>Juvenile-onset systemic lupus erythematosus (JSLE) is a rare autoimmune/inflammatory disease with significant morbidity and mortality. Neuropsychiatric (NP) involvement is a severe complication, encompassing a heterogeneous range of neurological and psychiatric manifestations.<h4>Methods</h4>Demographic, clinical, and laboratory features of NP-SLE were assessed in participants of the UK JSLE Cohort Study, and compared to patients in the same cohort without NP manifestations.<h4>Results</h4>A total of 428 JSLE patients were included in this study, 25% of which exhibited NP features, half of them at first visit. Most common neurological symptoms among NP-JSLE patients included headaches (78.5%), mood disorders (48.6%), cognitive impairment (42%), anxiety (23.3%), seizures (19.6%), movement disorders (17.7%), and cerebrovascular disease (14.9%). Peripheral nervous system involvement was recorded in 7% of NP-SLE patients. NP-JSLE patients more frequently exhibited thrombocytopenia (<100 × 10<sup>9</sup>/L) (<i>p</i> = 0.04), higher C-reactive protein levels (<i>p</i> = 0.01), higher global pBILAG score at first visit (<i>p</i> < 0.001), and higher SLICC damage index score at first (<i>p</i> = 0.02) and last (<i>p</i> < 0.001) visit when compared to JSLE patients without NP involvement.<h4>Conclusions</h4>A significant proportion of JSLE patients experience NP involvement (25%). Juvenile-onset NP-SLE most commonly affects the CNS and is associated with increased overall disease activity and damage.

Item Type: Article
Uncontrolled Keywords: Systemic lupus erythematosus, neuropsychiatric, central nervous system, peripheral nervous system, pediatric, juvenile
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Clinical Directorate
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 02 Nov 2021 13:30
Last Modified: 18 Jan 2023 21:25
DOI: 10.1177/09612033211045050
Open Access URL: https://doi.org/10.1177%2F09612033211045050
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3142509