Clinical features and outcome of neuropsychiatric lupus in Chinese: analysis of 240 hospitalized patients

Zhou, Hongmei; Zhang, Feng Chun; Tian, Xinping; Leng, Xiaomei; Lü, Juan; Zhao, Yan; Tang, Fu-lin; Zhang, X.; Zeng, Xiaofeng; Zhang, Z. L.; Zhang, W.; Dong, Yujie

doi:10.1177/0961203307085671

Cited by 58 publications

(43 citation statements)

References 29 publications

(32 reference statements)

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“…We found CI in a relevant percentage of Italian SLE patients, with an overall prevalence of 31% (19% mild, 7% moderate and 5% severe), a prevalence in the average when compared with results from previous studies that ranged between 6% and 79% [4], [10]–[14], [26]. Indeed, the prevalence of CI greatly varied between different cohorts.…”

Section: Discussionsupporting

confidence: 65%

Neurocognitive Dysfunction in Systemic Lupus Erythematosus: Association with Antiphospholipid Antibodies, Disease Activity and Chronic Damage

et al. 2012

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Introduction Systemic lupus erythematosus (SLE) is characterized by frequent neuropsychiatric involvement, which includes cognitive impairment (CI). We aimed at assessing CI in a cohort of Italian SLE patients by using a wide range of neurocognitive tests specifically designed to evaluate the fronto-subcortical dysfunction. Furthermore, we aimed at testing whether CI in SLE is associated with serum autoantibodies, disease activity and chronic damage. Methods Fifty-eight consecutive patients were enrolled. Study protocol included data collection, evaluation of serum levels of ANA, anti-dsDNA, anti-cardiolipin, anti-β 2 -glycoprotein I, anti-P ribosomal, anti-endothelial cell, and anti-Nedd5 antibodies. SLEDAI-2000 and SLICC were used to assess disease activity and chronic damage. Patients were administered a test battery specifically designed to detect fronto-subcortical dysfunction across five domains: memory, attention, abstract reasoning, executive function and visuospatial function. For each patient, the raw scores from each test were compared with published norms, then transformed into Z scores (deviation from normal mean), and finally summed in the Global Cognitive Dysfunction score (GCDs). Results Nineteen percent of patients had mild GCDs impairment (GCDs 2–3), 7% moderate (GCDs 4–5) and 5% severe (GCDs≥6). The visuospatial domain was the most compromised (MDZs = −0.89±1.23). Anti-cardiolipin IgM levels were associated with visuospatial domain impairment (r = 0.331, P = 0.005). SLEDAI correlated with GCDs, and attentional and executive domains; SLICC correlated with GCDs, and with visuospatial and attentional domains impairment. Conclusions Anti-phospholipids, disease activity, and chronic damage are associated with cognitive dysfunction in SLE. The use of a wide spectrum of tests allowed for a better selection of the relevant factors involved in SLE cognitive dysfunction, and standardized neuropsychological testing methods should be used for routine assessment of SLE patients.

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Section: Discussionsupporting

confidence: 65%

Neurocognitive Dysfunction in Systemic Lupus Erythematosus: Association with Antiphospholipid Antibodies, Disease Activity and Chronic Damage

et al. 2012

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“…Furthermore, we found that 76 NPSLE patients displayed 14 types of NP manifestations and that the most common NP manifestation in this population was seizure (47%), followed by delirium, headache, psychosis, and cerebrovascular disease, similar to the findings from another Chinese population. 13 However, seizure is less common in other ethnic populations of NPSLE patients. 22,23 In addition, while previous studies report only 3.7-7% of patients with delirium, [19][20][21][22] we found 26% of the NPSLE patients with delirium.…”

Section: Discussionmentioning

confidence: 99%

Clinical Manifestations of Neuropsychiatric Systemic Lupus Erythematosus in Chinese Patients

Fan

Zhou

et al. 2014

Arch Rheumatol

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“…ethnic, demographic, clinical differences (disease duration and activity, duration of followup)], rarity of some NP syndromes, or variability in the sensitivity of diagnostic tests assessing behavioral dysfunction [23,25]. Concerning morbidity and mortality, NPSLE is associated with increased global SLE disease activity, poorer prognosis and earlier mortality [26][27][28]. Recently, a study conducted on a large cohort of carefully phenotyped NPSLE investigated the causes of death and the characteristics associated with mortality [29].…”

Section: Npsle: Cns Involvement In Human Slementioning

confidence: 99%

Neuropsychiatric systemic lupus erythematosus and cognitive dysfunction: The MRL-lpr mouse strain as a model

Jeltsch-David

Muller

2014

Autoimmunity Reviews

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Mouse models of autoimmunity, such as (NZB×NZW)F1, MRL/MpJ-Fas(lpr) (MRL-lpr) and BXSB mice, spontaneously develop systemic lupus erythematosus (SLE)-like syndromes with heterogeneity and complexity that characterize human SLE. Despite their inherent limitations, such models have highly contributed to our current understanding of the pathogenesis of SLE as they provide powerful tools to approach the human disease at the genetic, cellular, molecular and environmental levels. They also allow novel treatment strategies to be evaluated in a complex integrated system, a favorable context knowing that very few murine models that adequately mimic human autoimmune diseases exist. As we move forward with more efficient medications to treat lupus patients, certain forms of the disease that requires to be better understood at the mechanistic level emerge. This is the case of neuropsychiatric (NP) events that affect 50-60% at SLE onset or within the first year after SLE diagnosis. Intense research performed at deciphering NP features in lupus mouse models has been undertaken. It is central to develop the first lead molecules aimed at specifically treating NPSLE. Here we discuss how mouse models, and most particularly MRL-lpr female mice, can be used for studying the pathogenesis of NPSLE in an animal setting, what are the NP symptoms that develop, and how they compare with human SLE, and, with a critical view, what are the neurobehavioral tests that are pertinent for evaluating the degree of altered functions and the progresses resulting from potentially active therapeutics.

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Clinical features and outcome of neuropsychiatric lupus in Chinese: analysis of 240 hospitalized patients

Cited by 58 publications

References 29 publications

Neurocognitive Dysfunction in Systemic Lupus Erythematosus: Association with Antiphospholipid Antibodies, Disease Activity and Chronic Damage

Neurocognitive Dysfunction in Systemic Lupus Erythematosus: Association with Antiphospholipid Antibodies, Disease Activity and Chronic Damage

Clinical Manifestations of Neuropsychiatric Systemic Lupus Erythematosus in Chinese Patients

Neuropsychiatric systemic lupus erythematosus and cognitive dysfunction: The MRL-lpr mouse strain as a model

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