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Abstract
Background and aims To look at the prevalence of neuropsychiatric manifestations in patients with SLE and assess its impact on qol
Methods We included consecutive patients with SLE above the age of 18 [(SLICC) 2012]. A diagnosis of an NP (neuropsychiatric) syndrome was made as per ACR 1999 definitions. Manifestations occurring at any point of time after the diagnosis of SLE were considered. Some modifications used were - headaches were included if >4 hours, mood disorders or anxiety was considered if the patient reported them to cause ‘significant distress or impairment in functioning’. Cognitive testing was done by using the mini-mental state examination (cut-off of 23). Testing for autonomic neuropathy only involved blood pressure response to standing (>=30/15 abnormal). Screening for neuropathy was done in only ¼ patients by NCS. Quality of life was assessed by EURO QOL 5D questionnaire
Results This study included 101 patients of SLE. Among these, 33 patients had neuropsychiatric manifestations with a total of 42 events. The most common manifestation was headache (10) followed by anxiety disorder (5) and peripheral neuropathy (9). Other NPSLE syndromes observed in the study are seizure (4), cognitive dysfunction (4), depression (4), acute confusional state (2), autonomic disorder (2), movement disorder (1) and multiple mononeuropathy (1). Mann-whitney U test showed that there was statistically significant differences in self-care score (p=0.002), limitation of mobility score (p=0.001), pain score(p=0.005) between NPSLE vs no NPSLE.
Comparison of basic descriptors among patients with and without NPSLE
Prevelance of Neuropsychiatric manifestations
Percentage of patients reporting problem in each
Conclusions NP manifestations are common and lead to significant reduction in qol in North Indian SLE patients.