PT - JOURNAL ARTICLE AU - Gerda M Steup-Beekman AU - Elisabeth J M Zirkzee AU - Danielle Cohen AU - Bastiaan M A Gahrmann AU - Bart J Emmer AU - Stefan C A Steens AU - Eduard L E M Bollen AU - Mark A van Buchem AU - Tom W J Huizinga TI - Neuropsychiatric manifestations in patients with systemic lupus erythematosus: epidemiology and radiology pointing to an immune-mediated cause AID - 10.1136/annrheumdis-2012-202369 DP - 2013 Apr 01 TA - Annals of the Rheumatic Diseases PG - ii76--ii79 VI - 72 IP - suppl 2 4099 - http://ard.bmj.com/content/72/suppl_2/ii76.short 4100 - http://ard.bmj.com/content/72/suppl_2/ii76.full SO - Ann Rheum Dis2013 Apr 01; 72 AB - Background Different pathogenetic pathways have been proposed for neuropsychiatric (NP) manifestations in systemic lupus erythematosus (SLE). Objective To describe the patient characteristics of a large cohort of patients with SLE with NP manifestations (NPSLE) in a single centre and to review whether these and other data are compatible with immune-mediated mechanisms. Methods A total of 212 patients were identified from MRI scans of the brain ordered for suspected NPSLE. Data were collected from the medical records. NP syndromes were classified according to the American College of Rheumatology (ACR) nomenclature and case definitions. Results 155 patients fulfilled the criteria for SLE. In 102 patients NP manifestations were attributed to SLE itself (primary NPSLE) whereas, in the remaining patients, the NP symptoms were due to other causes. The median age at the time of SLE diagnosis in patients with primary NPSLE was 27.5 years and the median duration prior to NPSLE was 2.8 years. Forty patients (39%) had a NP manifestation in the first year of the disease. Cerebrovascular disease, cognitive dysfunction, seizures and headache were the most prevalent syndromes. In 47% of patients with primary NPSLE the MRI scan of the brain showed no abnormalities. Conclusions Most NP manifestations in SLE occur early in the disease. This finding, as well as data from quantitative imaging studies and recent pathological studies, point to an immune-mediated pathogenesis.