Clinical Presentation of Neuropsychiatric Systemic Lupus Erythematosus and Demographic and Radiological Characteristics of Patients

Abstract

Introduction: Systemic lupus erythematosus (SLE) is a vasculitis that may affect numerous systems such as the kidneys, skin, joints, heart, lungs and nervous system. The purpose of our study is to evaluate patients with SLE in whom central nervous system involvement is monitored. Material and method: Files of 1028 patients who were followed up with systemic lupus erythematosus (SLE) diagnosis have been reviewed. Demographic, clinical and radiological characteristics were recorded for patients with a final diagnosis of neuropsychiatric systemic lupus erythematosus (NPSLE) with central involvement. Results: Among 1028 patients diagnosed with SLE, 1.07% had NPSLE. Mean age was 37+5.3. 90.9% of the patients (n = 10) were female, while 9.1% (n = 1) were male. From a clinical aspect, 45.4% complained from hemiparesis, 27.3% from headache, 18.2% from psychiatric complaints and 9.1% complained from impairment of consciousness. From a radiological aspect, 45.4% (n=5) were consistent with subcortical plaque, 36.4% (n=4) with ischemic stroke, 9.1% (n=1) with cerebral venous thrombosis, and 9.1% (n=1) appeared consistent with posterior reversible encephalopathy syndrome (PRES). Mortality rate was 9.1% (n=1). The central involvement type that caused mortality was ischemia. Conclusion: Since magnetic resonance imaging (MRI) is not sufficient for showing microvascular involvement in NPSLE patients, it is possible for NPSLE diagnosis to be delayed despite consistent clinical characteristics. In case of clinical suspicion, other imaging methods should be applied apart from MRI. This is because early diagnosis is an important factor that reduces morbidity and mortality.

Keywords

• Systemic Lupus Erythematosus;
• Central Nervous System;
• Magnetic Resonance Imaging

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