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Article: Neuropsychiatric manifestations and their clinical associations in southern Chinese patients with systemic lupus erythematosus
Title | Neuropsychiatric manifestations and their clinical associations in southern Chinese patients with systemic lupus erythematosus |
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Authors | |
Keywords | Anticardiolipin Antiphospholipid Central nervous system Lupus anticoagulant Neurological Psychiatric |
Issue Date | 2001 |
Publisher | Journal of Rheumatology Publishing Co Ltd. The Journal's web site is located at http://www.jrheum.com |
Citation | Journal Of Rheumatology, 2001, v. 28 n. 4, p. 766-771 How to Cite? |
Abstract | Objective. To study the neuropsychiatric (NP) manifestations in a large cohort of southern Chinese patients with systemic lupus erythematosus (SLE) according to the new 1999 American College of Rheumatology (ACR) case definitions and their clinical associations. Method. Patients with SLE who were followed from 1984 to 2000 were retrospectively reviewed. Patients with NP manifestations were ascertained and classified by at least 2 rheumatologists, with the collaboration of neurologists and psychiatrists. The association of NP manifestations with other clinical features and autoantibodies was studied by statistical analysis. Results. Five hundred eighteen patients with SLE were studied. The female to male ratio was 7.8 to 1 and the mean age of disease onset was 29.5 ± 12.0 years (range 9-80). The mean duration of follow-up was 7.3 ± 6.7 years (range 0.3-23.0). Ninety-six patients (19%) had 133 NP events and the mean number of events per patient-year of follow-up was 0.035. In decreasing order of frequency, these events were: seizure disorder (28%), cerebrovascular disease (19%), acute confusional state (14%), psychosis (11%), myelopathy (8%), mood disorder (6%), headache (4%), movement disorder (2%), cranial neuropathy (3%), demyelinating syndrome (1.5%), anxiety disorder (1.5%), mononeuritis multiplex/mononeuropathy (1.5%), aseptic meningitis (1%), and polyneuropathy (1%). Cognitive dysfunction was not classified because of the lack of standard neuropsychological testing for every patient. Univariate analysis revealed that NP-SLE was associated with a positive lupus anticoagulant (LAC) (p = 0.001), a strongly positive IgG anticardiolipin (aCL) (p = 0.01), leukopenia (p = 0.01), lymphopenia (p = 0.03), thrombocytopenia (p = 0.03), and pulmonary involvement (p = 0.03). Multivariate analysis showed that a strongly positive IgG aCL [RR 3.1 (1.3-7.7), p = 0.01] and a history of cyclophosphamide treatment [RR 4.3 (2.1-9.0), p < 0.001] were independently associated with NP manifestations in our cohort. Among the NP features, cerebrovascular disorder was particularly associated with the presence of LAC [OR 3.3 (1.4-8.0), p = 0.01] and a strongly positive IgG aCL [OR 3.1 (1.1-8.2), p = 0.03]. Conclusion. The point prevalence of overt NP manifestations in our cohort of patients with SLE was 19%. This percentage was likely higher if subtle cognitive dysfunction was included. Seizure and cerebrovascular disorders were the most common NP features. The presence of antiphospholipid antibodies was significantly associated with NP manifestations, especially cerebrovascular disorders. |
Persistent Identifier | http://hdl.handle.net/10722/162502 |
ISSN | 2023 Impact Factor: 3.6 2023 SCImago Journal Rankings: 1.128 |
ISI Accession Number ID | |
References |
DC Field | Value | Language |
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dc.contributor.author | Chi Chiu Mok | en_US |
dc.contributor.author | Chak Sing Lau | en_US |
dc.contributor.author | Wong, RWS | en_US |
dc.date.accessioned | 2012-09-05T05:20:34Z | - |
dc.date.available | 2012-09-05T05:20:34Z | - |
dc.date.issued | 2001 | en_US |
dc.identifier.citation | Journal Of Rheumatology, 2001, v. 28 n. 4, p. 766-771 | en_US |
dc.identifier.issn | 0315-162X | en_US |
dc.identifier.uri | http://hdl.handle.net/10722/162502 | - |
dc.description.abstract | Objective. To study the neuropsychiatric (NP) manifestations in a large cohort of southern Chinese patients with systemic lupus erythematosus (SLE) according to the new 1999 American College of Rheumatology (ACR) case definitions and their clinical associations. Method. Patients with SLE who were followed from 1984 to 2000 were retrospectively reviewed. Patients with NP manifestations were ascertained and classified by at least 2 rheumatologists, with the collaboration of neurologists and psychiatrists. The association of NP manifestations with other clinical features and autoantibodies was studied by statistical analysis. Results. Five hundred eighteen patients with SLE were studied. The female to male ratio was 7.8 to 1 and the mean age of disease onset was 29.5 ± 12.0 years (range 9-80). The mean duration of follow-up was 7.3 ± 6.7 years (range 0.3-23.0). Ninety-six patients (19%) had 133 NP events and the mean number of events per patient-year of follow-up was 0.035. In decreasing order of frequency, these events were: seizure disorder (28%), cerebrovascular disease (19%), acute confusional state (14%), psychosis (11%), myelopathy (8%), mood disorder (6%), headache (4%), movement disorder (2%), cranial neuropathy (3%), demyelinating syndrome (1.5%), anxiety disorder (1.5%), mononeuritis multiplex/mononeuropathy (1.5%), aseptic meningitis (1%), and polyneuropathy (1%). Cognitive dysfunction was not classified because of the lack of standard neuropsychological testing for every patient. Univariate analysis revealed that NP-SLE was associated with a positive lupus anticoagulant (LAC) (p = 0.001), a strongly positive IgG anticardiolipin (aCL) (p = 0.01), leukopenia (p = 0.01), lymphopenia (p = 0.03), thrombocytopenia (p = 0.03), and pulmonary involvement (p = 0.03). Multivariate analysis showed that a strongly positive IgG aCL [RR 3.1 (1.3-7.7), p = 0.01] and a history of cyclophosphamide treatment [RR 4.3 (2.1-9.0), p < 0.001] were independently associated with NP manifestations in our cohort. Among the NP features, cerebrovascular disorder was particularly associated with the presence of LAC [OR 3.3 (1.4-8.0), p = 0.01] and a strongly positive IgG aCL [OR 3.1 (1.1-8.2), p = 0.03]. Conclusion. The point prevalence of overt NP manifestations in our cohort of patients with SLE was 19%. This percentage was likely higher if subtle cognitive dysfunction was included. Seizure and cerebrovascular disorders were the most common NP features. The presence of antiphospholipid antibodies was significantly associated with NP manifestations, especially cerebrovascular disorders. | en_US |
dc.language | eng | en_US |
dc.publisher | Journal of Rheumatology Publishing Co Ltd. The Journal's web site is located at http://www.jrheum.com | en_US |
dc.relation.ispartof | Journal of Rheumatology | en_US |
dc.subject | Anticardiolipin | - |
dc.subject | Antiphospholipid | - |
dc.subject | Central nervous system | - |
dc.subject | Lupus anticoagulant | - |
dc.subject | Neurological | - |
dc.subject | Psychiatric | - |
dc.subject.mesh | Adolescent | en_US |
dc.subject.mesh | Adult | en_US |
dc.subject.mesh | Aged | en_US |
dc.subject.mesh | Aged, 80 And Over | en_US |
dc.subject.mesh | Cerebrovascular Disorders - Epidemiology | en_US |
dc.subject.mesh | Child | en_US |
dc.subject.mesh | China - Epidemiology | en_US |
dc.subject.mesh | Cognition Disorders - Epidemiology | en_US |
dc.subject.mesh | Cohort Studies | en_US |
dc.subject.mesh | Female | en_US |
dc.subject.mesh | Humans | en_US |
dc.subject.mesh | Lupus Erythematosus, Systemic - Epidemiology | en_US |
dc.subject.mesh | Lupus Vasculitis, Central Nervous System - Epidemiology - Psychology | en_US |
dc.subject.mesh | Male | en_US |
dc.subject.mesh | Middle Aged | en_US |
dc.subject.mesh | Prevalence | en_US |
dc.subject.mesh | Seizures - Epidemiology | en_US |
dc.title | Neuropsychiatric manifestations and their clinical associations in southern Chinese patients with systemic lupus erythematosus | en_US |
dc.type | Article | en_US |
dc.identifier.email | Chak Sing Lau:cslau@hku.hk | en_US |
dc.identifier.authority | Chak Sing Lau=rp01348 | en_US |
dc.description.nature | link_to_subscribed_fulltext | en_US |
dc.identifier.pmid | 11327248 | - |
dc.identifier.scopus | eid_2-s2.0-0035084171 | en_US |
dc.relation.references | http://www.scopus.com/mlt/select.url?eid=2-s2.0-0035084171&selection=ref&src=s&origin=recordpage | en_US |
dc.identifier.volume | 28 | en_US |
dc.identifier.issue | 4 | en_US |
dc.identifier.spage | 766 | en_US |
dc.identifier.epage | 771 | en_US |
dc.identifier.isi | WOS:000167808600015 | - |
dc.publisher.place | Canada | en_US |
dc.identifier.scopusauthorid | Chi Chiu Mok=7409717748 | en_US |
dc.identifier.scopusauthorid | Chak Sing Lau=14035682100 | en_US |
dc.identifier.scopusauthorid | Wong, RWS=34875928200 | en_US |
dc.identifier.issnl | 0315-162X | - |