Asadullah Khan*, Muhammad Haroon, Naveed Aslam Lashari, Saira Elaine Anwer Khan, Afshan Khanum and Sadia Asif
Objective: To determine the prevalence of Neuropsychiatri c Manifestations of Systemic Lupus Erythematous (NPSLE) among SLE patients attending a tertiary care rheumatology center and to compare it with a cohort of SLE with no neuropsychiatric features.
Methods and Materials: In this prospective cohort analysis , all SLE patients attending rheumatology department of Fatima Memorial Hospital during study period (January 2018 through to April 2019) were included. Association of demographic data and clinical manifestations of SLE with neuropsychiatric manifestations was studied and the cohort of NPSLE patients was compared with a cohort of SLE with no neuropsychiatric features.
Results: During the study period, 269 SLE patients attended our rheumatology department. After detailed clinical assessment and follow up, 54 patients wer e diagnosed with NPSLE features prevalence of about 21.1 % (57 out of 269 patients). Among central neurological ma nifestations, seizures were present in 21 (36.8%) patients, lupus associated headache in 12 (21%), stroke in 10 (17.5%) and acute psychosis in 11(19.2%) of patients. Peripheral nervous involvement comprising of mon neuritis multiplex and cranial neuropathy occurred in 2 (3.5%) and 1 (1.7%) respectively. On performing multiple regression analysis, a significant association of NPSLE features was noted with the presence of inflammatory arthritis (OR 15.8, CI 4.7-53, P<0.001), younger age at the diagnosis of SLE (OR 0.89, CI 0.81-0.97, p=0.01) and pyrexia (OR 10.7, CI 3.2-36, P<0.001).
Conclusion: NPSLE is present in 21.1% of patients with SLE. Presence of inflammatory arthritis, younger age of the development of SLE and episodes of pyrexia are predictive of NPSLE features.
