Background Neuropsychiatric systemic lupus erythematosus (NPSLE) presenting with mood disorder, headache, psychosis, and cognitive impairment appears within 1 year of SLE diagnosis in more than half of cases.1–2 Most studies have focused on the epidemiology of neuropsychiatric manifestations in patients with established SLE.3 Therefore, diagnosing NPSLE in patients who have visited the hospital with psychiatric symptoms is challenging. Although some studies have conducted anti-nuclear antibody (ANA) screening in psychiatric patients, none have occurred in an Asian population.4–5 We aimed to determine the benefits of ANA screening for NPSLE in patients admitted to the department of psychiatry in Korea.
Methods We investigated patients admitted to the department of psychiatry who underwent ANA testing between January 2015 and December 2021 at a single tertiary center in Korea. Patients diagnosed with SLE before admission were excluded from this study. Electronic medical records, including ANA titer, extractable nuclear antigen (ENA) were reviewed retrospectively. Diagnosis at psychiatric hospitalization was classified according to the International Classification of Diseases (ICD)-10.
Results Throughout the study period, 2523 patients were hospitalized, 1355 of whom underwent ANA testing. The median age of all patients was 40 (27–58), and 897 (66.2%) were female. Of the 1355 patients, 96 (7.1%) were positive with a titer of ≥1:80. Among the 17 patients who underwent ENA testing, 1 was positive for anti-Ro and anti-La, eventually diagnosed with Sjogren’s syndrome. According to the diagnostic classification of admission, there was no significant difference in the ANA positivity rate (p=0.205).
Conclusions There was no difference in the positivity rate of ANA in the general population when testing was performed for screening purposes on patients admitted to the psychiatric department. Additionally, none of the 1355 patients were diagnosed with NPSLE after undergoing ANA screening. Thus, the benefits of performing routine screening appear to be limited.
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Medicine (Baltimore) 2016 Nov;95(47):e5288 2
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