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ISRN Rheumatology
Volume 2012 (2012), Article ID 989218, 9 pages
http://dx.doi.org/10.5402/2012/989218
Clinical Study

Neuropsychiatric Features of a Cohort of Patients with Systemic Lupus Erythematosus

1Unidade de Doenças Auto-Imunes, Serviço 2-Medicina Interna, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Portugal
2Neurorradiologia, Área de Diagnóstico por Imagem, Hospital de São José, Centro Hospitalar Lisboa Central, Portugal
3Laboratório de Imunologia, Serviço de Imuno-Hemoterapia, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Portugal
4Laboratório de Hemostase, Serviço de Imuno-Hemoterapia, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Portugal

Received 23 September 2012; Accepted 10 October 2012

Academic Editors: J. Bruges Armas, G. Murdaca, and E. Tchetina

Copyright © 2012 Maria Francisca Moraes-Fontes et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In order to establish if neuropsychiatric systemic lupus erythematosus (NPSLE) can be identified by any characteristic other than those used to diagnose the neuropsychiatric (NP) disease itself, we retrospectively reviewed 98 systemic lupus erythematosus (SLE) patients followed over a mean period of 10 years. NPSLE was identified in 22 patients. Stroke and generalized seizures were the most frequent NP manifestations. The NPSLE and non-NPSLE groups were similar with regard to demographic characteristics, ACR criteria, serum autoantibodies, and frequency of hypertension and hypercholesterolemia. Of note, compared to the non-NPSLE group, NPSLE was associated with a higher frequency of smoking (78 versus 26%), organ damage (73 versus 34%), and cumulative mortality rate (14 versus 7%). The series of patients was further analysed according to the presence of antiphospholipid syndrome (APS). Significantly, the interval between the onset of NP disease and SLE diagnosis was shorter in the APS ( years) than in the APS+ ( years) groups. Recurrence and/or persistence of NP events were only documented in the APS group. Overall cumulative mortality was highest in NPSLE and in APS+ patients with inadequate anticoagulation control, identifying an aspect that requires improved vigilance and the development of novel therapeutic modalities.