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AB0708 Neuropsychiatric manifestations in systemic lupus erythematosus: About 80 tunisian patients
  1. S. Sayhi1,
  2. F. Ajili1,
  3. I. Gharsallah1,
  4. L. Metoui1,
  5. S. Kouki2,
  6. N. Benabdelhafidh1,
  7. J. Laabidi1,
  8. B. Louzir1,
  9. F. Msaddak1,
  10. N. Ben Abdallah2,
  11. S. Othmani1
  1. 1Department of Internal Medicine
  2. 2Department of Radiology, Military Hospital of Tunis, Monfleury, Tunisia

Abstract

Background Systemic lupus erythematosus (SLE) is a relapsing-remitting autoimmune disease. The frequency of neuropsychiatric manifestations in SLE studies varies widely, depending on the type of manifestations included and the methods used for evaluation. Neuropsychiatric (NP) manifestations may be considered primary if directly related to SLE activity, or secondary when related to treatment, infections, metabolic abnormalities or other systemic manifestations such as uremia and hypertension.

Objectives To evaluate the prevalence and characteristics of different neurological and psychiatric presentations in patients admitted to the department of Internal Medicine of the Military Hospital of Tunis hospital with systemic lupus erythematosus (SLE).

Methods In this retrospective hospital-based study, we examined the medical records of 80 patients with SLE from 2000 to 2010 in our department. All patients fulfilled the criteria of the American College of Rheumatology (ACR).

Results Eighteen (80) SLE patients were included in the study. The prevalence of neuropsychiatric syndromes in our study was estimated to be 27% and the most frequent NP syndromes were headaches (28%), seizures (27%) and cognitive dysfunctions (21%). Meningitis, convulsions and cerebrovascular events were found respectively in: 16 cases (21%), 11 cases (16%) and 6 cases (7%). One patient had an optic neuropathy and onether extrapyramidal syndrome. No cases of plexopathy or Guillain-Barré syndrome were reported. MRI abnormalities were found in 21 cases (27%).Glucocorticoids and immunosuppressive therapy were indicated when NP manifestations were thought to reflect an inflammatory process in SLE(optic neuritis, refractory seizures, psychosis) and in the presence of generalized lupus activity. Antiplatelet and anticoagulation therapy were indicated when manifestations are related to antiphospholipid syndrome.

Conclusions The prevalence and nature of different neurological presentations of SLE in Tunisian patients has some similarities to that reported in the literature. Differences are due to ethnic and environmental factors

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  2. Weiner SM, Peter NH. Neuropsychiatric involvement in systemic lupus erythematosus: Part 1: Clinical presentation and pathogenesis. Med Klin (Munich) 2002;97:730-7.

  3. Futrell N, Schultz LR, Millikan C. Central nervous system disease in patients with systemic lupus erythematosus. Neurology 1992;42:1649-57.

Disclosure of Interest None Declared

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