Abstract
Results There were 120 children with SLE followed during the study period: 93 female (77.5%, M:F 3.4:1); 61 Hispanic (50.8%) and 34 African-American (28.3%). NPSLE affected 15 children (12.5%). Cognitive dysfunction was the most common manifestation, followed by significant headache, seizures, psychosis, and focal neurologic signs. NPSLE was diagnosed in the first year in 10/15 patients (67%). Abnormalities of brain magnetic resonance imaging were encountered in 10 patients (67%). Children with NPSLE had a significantly greater number of co-morbidities (end-stage renal disease, thrombocytopenia, and pancreatitis) than unaffected children with SLE (p<0.05). NPSLE was associated with a higher SLEDAI at diagnosis and the presence of anti-Smith antibodies (p<0.05). All patients received high-dose corticosteroid and cyclophosphamide. NPSLE was associated with the occurrence of major infections, as well as a higher SLICC damage index, and mortality (p<0.05). Conclusions In this cohort NPSLE was associated with co-morbidities, major infections, and higher damage scores.
Highlights
Neuropsychiatric manifestations (NPSLE) are common in children with lupus, and are reported to be associated with worse prognosis
NPSLE was defined according to American College of Rheumatology criteria
There were 120 children with SLE followed during the study period: 93 female (77.5%, M:F 3.4:1); 61 Hispanic (50.8%) and 34 African-American (28.3%)
Summary
Neuropsychiatric manifestations (NPSLE) are common in children with lupus, and are reported to be associated with worse prognosis. P Costa Reis1,2*, S Nativ2, J Isgro2, C Yildirim-Toruner2, L Imundo2, A Eichenfield2 From 18th Pediatric Rheumatology European Society (PReS) Congress Bruges, Belgium. Background Neuropsychiatric manifestations (NPSLE) are common in children with lupus, and are reported to be associated with worse prognosis. Aim To describe the clinical characteristics of children with NPSLE, including co-morbidities, damage, and mortality. Methods Retrospective chart review of the clinical, laboratory, and radiographic features of SLE patients diagnosed before the age of 18 and followed at MSCHONY/CUMC in 2007-2009.
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