Neuropsychiatric involvement in juvenile-onset systemic lupus erythematosus: A multicenter study

Kısaarslan, Ayşenur; Çiçek, Sümeyra; BATU AKAL, EZGİ; Şahin, Sezgin; Gürgöze, Metin; Çetinkaya, Sibel; Ekinci, Miray; ATMIŞ, BAHRİYE; BARUT, KENAN; Adrovic, Amra; Ağar, Buket; Şahin, NİHAL; Demir, Ferhat; Bağlan, Esra; Kara, Mehtap; Selçuk, Şenay; Özdel, Semanur; Çomak, Elif; Akkoyunlu, Betül; Yener, Gülçin; Yıldırım, Deniz; Öztürk, Kübra; Yıldız, Mehmet; Haşlak, Fatih; Şener, SEHER; Kısaoğlu, Hakan; Baba, Özge; Kızıldağ, Zehra; İşgüder, Rana; Çağlayan, Şengül; Bilgin, Raziye; Aytaç, Gülçin; Yücel, Burcu; Tanatar, Ayşe; Sönmez, Hafize; Çakan, Mustafa; Kara, Aslıhan; Elmas, Ahmet; Kılıç, Beltinge; Ayaz, Nuray; Kasap, Belde; Acar, Banu; Ozkaya, Ozan; Yüksel, Selçuk; Bakkaloğlu, Sevcan; Aydoğ, Özlem; Aksu, Güzide; Akman, Sema; Dönmez, Osman; Bülbül, Mehmet; Büyükçelik, Mithat; Tabel, Yılmaz; Sözeri, Betül; Kalyoncu, Mukaddes; Bilginer, YELDA; Poyrazoğlu, Muammer; Ünsal, Erbil; Kasapçopur, Özgür; Özen, SEZA; Düşünsel, Ruhan

doi:10.1016/j.jbspin.2023.105559

Neuropsychiatric involvement in juvenile-onset systemic lupus erythematosus: A multicenter study

Atıf İçin Kopyala

Kısaarslan A. P., Çiçek S. Ö., BATU AKAL E. D., Şahin S., Gürgöze M. K., Çetinkaya S. B., ...Daha Fazla

Joint Bone Spine, cilt.90, sa.4, 2023 (SCI-Expanded)

Yayın Türü: Makale / Tam Makale
Cilt numarası: 90 Sayı: 4
Basım Tarihi: 2023
Doi Numarası: 10.1016/j.jbspin.2023.105559
Dergi Adı: Joint Bone Spine
Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CINAHL, EMBASE, MEDLINE
Anahtar Kelimeler: Cluster, Juvenile, Neurologic manifestations, Systemic lupus erythematosus
Hacettepe Üniversitesi Adresli: Evet

Özet

Introduction: Neuropsychiatric (NP) involvement is a restricted area in juvenile-onset systemic lupus erythematosus (jSLE). Aim: To investigate the prevalence, demographic and clinical features, and outcomes of the neurological involvement in the Turkish jSLE population. Methods: This study was based upon 24 referral centers’ SLE cohorts, multicenter and multidisciplinary network in Turkey. Patient data were collected by a case report form which was standardized for NP definitions according to American Collage of Rheumatology (ACR). Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) neuropsychiatric part was used to determine NP damage. Variables were evaluated Ward's hierarchical clustering analyses, univariate, and multivariate logistic regression analyses. Results: A hundred forty-nine of 1107 jSLE patients had NP involvement (13.5%). The most common NPSLE findings were headache (50.3%), seizure (38.3%), and acute confusional state (33.6%). Five clusters were identified with all clinical and laboratory findings. The first two clusters involved neuropathies, demyelinating diseases, aseptic meningitis, and movement disorder. Cluster 3 involved headache, activity markers and other SLE involvements. Idiopathic intracranial hypertension, cerebrovascular disease, cognitive dysfunction, psychiatric disorders and SLE antibodies were in the fourth, and acute confusional state was in the fifth cluster. In multivariate analysis, APA positivity; OR: 2.820, (%95CI: 1.002–7.939), P: 0,050, plasmapheresis; OR: 13.804 (%95CI: 2.785–68.432), P: 0,001, SLEDAI scores; OR: 1.115 (%95CI: (1.049–1.186), P: 0,001 were associated with increased risk for neurologic sequelae. Conclusion: We detected the prevalence of juvenile NPSLE manifestations in Turkey. We have identified five clusters that may shed light pathogenesis, treatment and prognosis of NP involvements. We also determined risk factors of neurological sequelae. Our study showed that new definitions NP involvements and sequelae for childhood period are needed.