SLENeuropsychiatric Syndromes in Systemic Lupus Erythematosus: A Meta-Analysis
Section snippets
Methods
This study was conducted according to the guidelines outlined by the Meta-analysis of Observational Studies in Epidemiology (MOOSE) group (20).
Results
Our search identified 112 articles (Fig. 1), of which 17 met the inclusion criteria and were incorporated in the final analysis (Table 1). The final cohort comprised of 5057 SLE patients. Of these, 1439 patients (28.5%, range: 12.2%-94.7%) had 2709 NP syndromes (mean of 1.88 syndromes per NPSLE patient, range: 1.0-3.48). Most studies were single-center (13/17 studies) and reported on an adult population (8/17, N = 3782 patients), although some studies reported on either pediatric (5/17, N =
Methodologic Differences Between Studies
We identified 2 major methodologic approaches used in the 17 studies. The first (applied in 7/17 studies) was purely a retrospective, chart-driven one and therefore prone to biases such as low-quality patient records and underestimation of the subjective manifestations (eg, headache). The second approach (used in 10/17 studies) combined a retrospective chart review with either a prospective follow-up or additional elicited information (eg, questionnaires about past medical history, additional
Conclusion
Ours is the first study to compile the body of data on NPSLE prevalence using the 1999 ACR case definitions, a decade after their publication. NP syndromes were estimated to exist in more than half of SLE patients, making it one of the most common and significant manifestations of SLE. Many of the NP syndromes, such as cognitive dysfunction and autonomic disorders, may be difficult to detect and may require careful testing of all patients to avoid underdiagnosis.
Determining the prevalence of
Acknowledgment
We would like to thank Dr. Yedidya Dotan for his important remarks and assistance with the statistical analysis.
References (50)
- et al.
Neuropsychiatric features of systemic lupus erythematosus
Autoimmun Rev
(2005) - et al.
Meta-analysis in clinical trials
Control Clin Trials
(1986) - et al.
The role of autoantibodies in pediatric neuropsychiatric systemic lupus erythematosus
Autoimmun Rev
(2007) - et al.
High prevalence of systemic lupus erythematosus in 78 myasthenia gravis patients: a clinical and serologic study
Am J Med Sci
(2006) - et al.
What have we learned from a 10-year experience with the LUMINA (Lupus in Minorities; Nature vs. nurture) cohort?Where are we heading?
Autoimmun Rev
(2004) - et al.
Autoantibodies involved in neuropsychiatric SLE and antiphospholipid syndrome
Semin Arthritis Rheum
(2007) The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes
Arthritis Rheum
(1999)- et al.
Association of anti-ribosomal P protein antibodies with neuropsychiatric and other manifestations of systemic lupus erythematosus
Clin Rheumatol
(2008) - et al.
Cerebral and corpus callosum atrophy in systemic lupus erythematosus
Arthritis Rheum
(2005) - et al.
Clinical features and outcome of neuropsychiatric lupus in Chinese: analysis of 240 hospitalized patients
Lupus
(2008)
Clinical, laboratory and neuroimage findings in juvenile systemic lupus erythematosus presenting involvement of the nervous system
Arq Neuropsiquiatr
A follow up study of antiphospholipid antibodies and associated neuropsychiatric manifestations in 137 children with systemic lupus erythematosus
Arthritis Rheum
The incidence and prevalence of neuropsychiatric syndromes in pediatric onset systemic lupus erythematosus
J Rheumatol
Neuropsychiatric damage in Southern Chinese patients with systemic lupus erythematosus
Medicine (Baltimore)
Neuropsychiatric lupus syndromes: relationship with antiphospholipid antibodies
Neurology
Neuropsychiatric manifestations in pediatric systemic lupus erythematosus and association with antiphospholipid antibodies
J Rheumatol
Neuropsychiatric manifestations in pediatric systemic lupus erythematosus: a 20-year study
Lupus
Neuropsychiatric manifestations in systemic lupus erythematosus: prevalence and association with antiphospholipid antibodies
J Rheumatol
Neuropsychiatric manifestations systemic lupus erythematosus: a study from South India
Neurol India
Neuropsychiatric syndromes in lupus: prevalence using standardized definitions
Neurology
The prevalence of neuropsychiatric syndromes in systemic lupus erythematosus
Neurology
Neuropsychiatric manifestations and their clinical associations in southern Chinese patients with systemic lupus erythematosus
J Rheumatol
Raised serum S100B protein levels in neuropsychiatric lupus
Ann Rheum Dis
Short-term outcome of neuropsychiatric events in systemic lupus erythematosus upon enrollment into an international inception cohort study
Arthritis Rheum
Meta-analysis of observational studies in epidemiology: a proposal for reportingMeta-analysis Of Observational Studies in Epidemiology (MOOSE) group
JAMA
Cited by (248)
Systemic Lupus Erythematous Presenting as a Grand Mal Seizure: Case Report
2023, Journal of Emergency NursingCatatonia and Cotard's Syndrome in a Patient With Systemic Lupus Erythematosus: A Case Report
2023, Revista Colombiana de PsiquiatriaInteraction of 5-HTTLPR and SLE disease status on resting-state brain function
2024, Arthritis Research and Therapy
The authors have no conflicts of interest to disclose.