Background Juvenile Onset Systemic Lupus Erythematosus (JO-SLE) is a chronic and multisystemic autoimmune disease, which appears before 16 years old and a variable clinical spectrum. Neuropsychiatric involvement in Juvenile SLE results in significant morbidity and mortality.
Objectives To assess Neuropsychiatric manifestations of SLE (NPSLE) in JO-SLE patients and study the predictors and relation to disease characteristics
Methods 112 Juvenile onset SLE patients were included in the study; 36 with NPSLE and 76 without. Disease activity and damage were assessed using the Systemic lupus erythematosus disease activity index (SLEDAI) and Systemic Lupus International Collaborating Clinics/Damage Index (SLICC/ACR DI) respectively. Detailed neurological examination was performed and manifestations reported for those with NPSLE.
Results Neuropsychiatric manifestations of the SLE patients included lupus cerebritis and hallucinations (n=32), psychosis (n=8), seizures (n=8), stroke and weakness (n=5), peripheral neuritis (n=7), Headache (n=4), cognitive impairment (n=3), transverse myelitis (2) and depression (1). The age, disease duration and BMI were significantly increased in those with NPSLE (p=0.009, p=0.014 and p=0.011 respectively). They were associated with more frequent lupus nephritis (p=0.015) however the renal biopsy classes were comparable. The SLEDAI and SLICC tended to be higher in those with NPSLE (p=0.15 and p=0.06 respectively). Twenty-one patients were children with Juvenile SLE (12.81±2.28 years) while 91 were adult SLE cases with juvenile onset (23.18±3.87 years). There was no significant difference in the frequency of NPSLE among both age groups (p=0.21) though higher in the adults with JO-SLE. None of the studied variables would significantly predict NPSLE however, only the BMI tended to.
Conclusions Pediatric rheumatologists should be aware of the frequency of neuropsychiatric disturbances in Juvenile-onset SLE children as adults. The neuropsychiatric disorders do not always correlate with disease activity or damage but should be looked for in cases with overt lupus nephritis.
Disclosure of Interest None declared