Abstract
Background Systemic Lupus Erythematosus (SLE) is an autoimmune disease characterized by multiple organ involvement. Neuropsychiatric involvement is seen in 20–27% of patients. Approximately 1/4 of diagnosed SLE patients develop neuropsychiatric SLE 2 years after diagnosis.
Methods The aim of this study was to determine the risk groups before developing neurological, psychiatric and cognitive involvement and symptoms in SLE patients and to take measures and to develop cheaper and more applicable algorithms.
Results Ninety eight children and adolescents were included in the study. 61 (62.2%) of the patients were female and 37 (37.8%) were male. Research group included 34 (34.7%) SLE patients, 31 (31.6%) JIA patients, and 33 (33.7%) healthy children and adolescents. The median age of the patients was 17 (12–21) years, and the median follow-up period was 4 years (0–13). The median SLEDAI of the patients was 2 points (0–19). As a result of psychiatric screening, separation anxiety disorder, generalized anxiety disorder and specific phobia were significantly more common in SLE patients than in healthy controls (respectively p=0,054, p=0,052, p=0,018). The Wechsler Intelligence Scale for Children-IV (WISC-IV) was applied to children and adolescents. In the test results, Perceptual Reasoning Converted Index (PRCI) and Perceptual Reasoning Standard Index (PRSI) were significantly lower in SLE patients compared to the healthy control group (respectively p=0,039, p=0,046). The ‘comprehension’ subtest, ‘symbol search’ subtest and Verbal Comprehension Standard Index (VCSI) were found significantly lower in SLE patients compared to the healthy control group (respectively p=0,046, p=0,017, p=0,036).
Conclusion This study is the first in the literature about this field. It is important to show early neuropsychiatric involvement with neurocognitive and neuropsychological tests in pediatric SLE patients. We also examined the incidence of psychiatric diagnosis in SLE patients. SLE patients should be evaluated with neurocognitive and neuropsychological tests regardless of disease activity, even though they do not have neurological signs and symptoms. Patients should be closely monitored for neuropsychiatric involvement and tests should be repeated if necessary.
Keywords Systemic Lupus Erythematosus (SLE), SLEDAI, Neuropsychiatric SLE (NPSLE), neurocognitive disorder, neuropsychological assessment, psychometric test, psychiatric screening, WISC-IV, WISC-IV subtests, closters of WISC-IV score
