Neuropsychiatric Manifestations of Systemic Lupus Erythematosus: Diagnosis, Clinical Spectrum, and Relationship to Other Features of the Disease

Feinglass, Edward J.; Arnett, Frank C.; Dorsch, Carole A.; Zizic, Thomas M.; Stevens, Mary Betty

doi:10.1097/00005792-197607000-00004

Cited by 500 publications

(229 citation statements)

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“…Significant differences in renal, neuropsychiatric and total DS developed between 1 and 5 yr after diagnosis, as have been described previously for both renal [13] and neuropsychiatric involvement [14,15] within 5yr of diagnosis. However, our data suggest that disease progression within the first 10 yr in Caucasians is slower than for Afro-Caribbeans or Asians.…”

Section: Discussionsupporting

confidence: 78%

Slicc/Acr Damage Index Is Valid, and Renal and Pulmonary Organ Scores Are Predictors of Severe Outcome in Patients With Systemic Lupus Erythematosus

Stoll¹,

Seifert²,

Isenberg³

1996

Rheumatology

222

139

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SUMMARYWe investigated the Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) Damage Index as a predictor of severe outcome and an indicator of morbidity in different ethnic groups, and in regard to its validity. We retrospectively studied disease course within 10 yr of diagnosis in an inception cohort of 80 patients with systemic lupus erythematosus (SLE). The mean renal damage score (DS) at 1 yr after diagnosis was a significant predictor of endstage renal failure and the mean pulmonary DS at 1 yr significantly predicted death within 10 yT of diagnosis. Compared to Caucasians, Afro-Caribbeans and Asians had significantly higher mean total DS at 5 and 10 yr, and higher mean renal DS at 10 yr. At 5 yr, the mean renal DS in Afro-Caribbeans and the mean neuropsychiatric DS in Asians were significantly higher than in Caucasians. The rate of endstage renal failure in Caucasians was significantly lower than in the other ethnic groups. Our results confirm the validity of the SLICC/ACR Damage Index.

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Section: Discussionsupporting

confidence: 78%

Slicc/Acr Damage Index Is Valid, and Renal and Pulmonary Organ Scores Are Predictors of Severe Outcome in Patients With Systemic Lupus Erythematosus

Stoll¹,

Seifert²,

Isenberg³

1996

Rheumatology

222

139

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“…In contrast, cognitive impairment has not always been associated with excess morbidity (19)(20)(21). Although some studies have shown increased mortality in patients with NP disease (22)(23)(24)(25)(26), others have not (7,15,27,28).…”

Section: Discussionmentioning

confidence: 99%

Neuropsychiatric events at the time of diagnosis of systemic lupus erythematosus: An international inception cohort study

Hanly

Urowitz

Sánchez‐Guerrero

et al. 2007

Arthritis & Rheumatism

269

217

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Objective. To describe the prevalence, characteristics, attribution, and clinical significance of neuropsychiatric (NP) events in an international inception cohort of systemic lupus erythematosus (SLE) patients.Methods. The study was conducted by the Systemic Lupus International Collaborating Clinics (SLICC). Patients were enrolled within 15 months of fulfilling the American College of Rheumatology (ACR) SLE classification criteria. All NP events within a predefined enrollment window were identified using the ACR case definitions of 19 NP syndromes. Decision rules were derived to determine the proportion of NP disease attributable to SLE. Clinical significance was determined using the Short Form 36 (SF-36) Health Survey and the SLICC/ACR Damage Index (SDI).Results. A total of 572 patients (88% female) were recruited, with a mean ؎ SD age of 35 ؎ 14 years. The mean ؎ SD disease duration was 5.2 ؎ 4.2 months. Within the enrollment window, 158 of 572 patients (28%) had at least 1 NP event. In total, there were 242 NP events that encompassed 15 of 19 NP syndromes. The proportion of NP events attributed to SLE varied from 19% to 38% using alternate attribution models and occurred in 6.1-11.7% of patients. Those with NP events, regardless of attribution, had lower scores on the SF-36 and higher SDI scores compared with patients with no NP events.Conclusion. Twenty-eight percent of SLE patients experienced at least 1 NP event around the time of diagnosis of SLE, of which only a minority were attributed to SLE. Regardless of attribution, the occurrence of NP events was associated with reduced quality of life and increased organ damage.Nervous system involvement as part of systemic lupus erythematosus (SLE) is well recognized, although the prevalence is highly variable among studies (1-7). A wide range of neuropsychiatric (NP) manifestations have been described, which span common features such Dr. Hanly

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“…These complications include seizures, stroke, psychosis, transverse myelitis and chorea. 33,34 There is also evidence that a subgroup of SLE patients have cognitive impairments, including some without clinically obvious neuropsychiatry symptoms. 35,36 Also in humans, an increase in aPL was proposed to be the reason for the cognitive impairment.…”

Section: Lack Of Cd95 Leads To Neurobehavioral Deficitsmentioning

confidence: 99%

Control of neuronal branching by the death receptor CD95 (Fas/Apo-1)

et al. 2005

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The CD95 (Apo-1/Fas)/CD95 ligand (CD95L) system is best characterized as a trigger of apoptosis. Nevertheless, despite broad expression of CD95L and CD95 in the developing brain, absence of functional CD95 (lpr mice) or CD95L (gld mice) does not alter neuronal numbers. Here, we report that in embryonic hippocampal and cortical neurons in vivo and in vitro CD95L does not induce apoptosis. Triggering of CD95 in cultured immature neurons substantially increases neurite branches by promoting their formation. The branching increase occurs in a caspase-independent and death domain-dependent manner and is paralleled by an increase in the nonphosphorylated form of Tau. Most importantly, lpr and gld mutants exhibit a reduced number of dendritic branches in vivo at the time when synapse formation takes place. These data reveal a novel function for the CD95 system and add to the picture of guidance molecules in the developing brain.

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Neuropsychiatric Manifestations of Systemic Lupus Erythematosus: Diagnosis, Clinical Spectrum, and Relationship to Other Features of the Disease

Cited by 500 publications

References 0 publications

Slicc/Acr Damage Index Is Valid, and Renal and Pulmonary Organ Scores Are Predictors of Severe Outcome in Patients With Systemic Lupus Erythematosus

Slicc/Acr Damage Index Is Valid, and Renal and Pulmonary Organ Scores Are Predictors of Severe Outcome in Patients With Systemic Lupus Erythematosus

Neuropsychiatric events at the time of diagnosis of systemic lupus erythematosus: An international inception cohort study

Control of neuronal branching by the death receptor CD95 (Fas/Apo-1)

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