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Article: Neuropsychiatric manifestations and their clinical associations in southern Chinese patients with systemic lupus erythematosus

TitleNeuropsychiatric manifestations and their clinical associations in southern Chinese patients with systemic lupus erythematosus
Authors
Issue Date2001
PublisherJournal 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?
AbstractObjective. 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 Identifierhttp://hdl.handle.net/10722/162502
ISSN
2015 Impact Factor: 3.236
2015 SCImago Journal Rankings: 1.225
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChi Chiu Moken_US
dc.contributor.authorChak Sing Lauen_US
dc.contributor.authorWong, RWSen_US
dc.date.accessioned2012-09-05T05:20:34Z-
dc.date.available2012-09-05T05:20:34Z-
dc.date.issued2001en_US
dc.identifier.citationJournal Of Rheumatology, 2001, v. 28 n. 4, p. 766-771en_US
dc.identifier.issn0315-162Xen_US
dc.identifier.urihttp://hdl.handle.net/10722/162502-
dc.description.abstractObjective. 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.languageengen_US
dc.publisherJournal of Rheumatology Publishing Co Ltd. The Journal's web site is located at http://www.jrheum.comen_US
dc.relation.ispartofJournal of Rheumatologyen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshCerebrovascular Disorders - Epidemiologyen_US
dc.subject.meshChilden_US
dc.subject.meshChina - Epidemiologyen_US
dc.subject.meshCognition Disorders - Epidemiologyen_US
dc.subject.meshCohort Studiesen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshLupus Erythematosus, Systemic - Epidemiologyen_US
dc.subject.meshLupus Vasculitis, Central Nervous System - Epidemiology - Psychologyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPrevalenceen_US
dc.subject.meshSeizures - Epidemiologyen_US
dc.titleNeuropsychiatric manifestations and their clinical associations in southern Chinese patients with systemic lupus erythematosusen_US
dc.typeArticleen_US
dc.identifier.emailChak Sing Lau:cslau@hku.hken_US
dc.identifier.authorityChak Sing Lau=rp01348en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid11327248-
dc.identifier.scopuseid_2-s2.0-0035084171en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0035084171&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume28en_US
dc.identifier.issue4en_US
dc.identifier.spage766en_US
dc.identifier.epage771en_US
dc.identifier.isiWOS:000167808600015-
dc.publisher.placeCanadaen_US
dc.identifier.scopusauthoridChi Chiu Mok=7409717748en_US
dc.identifier.scopusauthoridChak Sing Lau=14035682100en_US
dc.identifier.scopusauthoridWong, RWS=34875928200en_US

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