Article Text
Abstract
Background Patients with juvenile-onset Systemic Lupus Erythematosus (jSLE) cope with physical and neuropsychiatric symptoms which may interfere with social and professional activities. Mild cognitive impairment may negatively impact quality of life and academic performance. We intend to assess cognitive state in JSLE and to explore laboratory and clinical markers associated with the presence of mild cognitive impairment.
Methods Thirty jSLE patients, currently aged ≥16 years, followed in an outpatient’s unit performed the Mini Mental State Examination (MMSE) for cognitive testing; clinical and laboratory measures were collected from clinical records. Juvenile-onset was defined as age at diagnosis <18 years. Statistical analyses were performed with SPSS software, version 25.
Results The mean age was 22.8(5.3) years with 90% females. Patients had a mean of 12.7(2.3) years of formal education. A mean MMSE of 27.7 (1.9) was found, and 23.3% of the population showed mild cognitive impairment. MMSE scores were negatively correlated with C-Reactive Protein (CRP) (r=-0.38, p=0.44) and platelet count (r=-0.37, p=0.44). Additionally, patients presenting positive anti-SSA (n=10), anti-RNP (n=4) and anti-SM (n=4) autoantibodies, scored significantly lower MMSE scores compared to patients without these autoantibodies (p=0.029; p=0.017 and p=0.017, respectively).
Conclusions Our population showed a low mean MMSE score, regardless of their educational level and age. The consistent relationship between the presence of cognitive impairment, higher inflammatory activity and autoantibodies frequently associated with neuropsychiatric involvement in jSLE seems to point to the need to screen jSLE populations for mild cognitive impairment with larger studies being required.