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Evaluation of Neurological Manifestations of Systemic Lupus Erythematosus

 

Abstract

Background: Neuropsychiatric symptoms are typical consequences in patients with systemic lupus erythematosus (SLE). There is no apparent link between the clinical parameters of SLE patients and the development of neuropsychiatric symptoms.

Objectives: to determine the incidence of neurological manifestations and the risks associated with them in SLE patients.

Patients and Methods: This is a case-series study comprised 65 patients who visited the rheumatology Department at Baghdad Teaching Hospital/Medical City between January 2022 and February 2023. All patients' demographic and clinical data, including age, gender, disease duration, type and duration of treatment, general signs of the disease, and neurological and psychiatric manifestations of SLE, were collected. Laboratory data comprised plasma anti-phospholipid antibodies (aPL), anti-double stranded DNA (anti-dsDNA), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). The cognitive dysfunction was assessed using the six-item cognitive impairment test (6CIT).

Results: Out of 65 patients, 34 (52.3%) were found to have at least one neuropsychiatric SLE (NPSLE) manifestation. Headache and depression were the most common NPSLE manifestation encountered in 36 patients (55.4%) followed by psychosis (21.5%), neuropathy (16.9%) and stroke and seizure (13.5%). In multivariate analysis, each of age >35 years (OR= 2.92, 95%CI= 1.12-34.2, p= 0.10), disease duration >5 years (4.45, 95%CI=1.23-28.43, p= 0.001), anti-phospholipid Abs (OR= 4.22, 95%CI= 1.17-89.38, p= 0.036), lupus nephritis (OR= 6.34, 95%CI= 1.27- 64.98, p= 0.029) and 6CIT>3 (OR= 5.83, 95%CI= 1.55- 21.87, p= 0.009) are independent predictors for NPSLE in patients with SLE.

Conclusions: Neuropsychiatric manifestations developed in more than half of the SLE cases studied within up to six-year of disease duration. Headache and depression, psychosis and neuropathy are the most common NPSLE manifestations. Older age and longer disease duration are risk factors for development of NPSLE. Clinically, anti-phospholipid antibodies, lupus nephritis and a high score of the six-item cognitive impairment test (>8) are predictors for NPSLE.

Received: May, 2023

Accepted: Sept., 2023

Published: Jan., 2024

 

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Publication Date
Sun Oct 30 2022
Journal Name
Iraqi Journal Of Science
Evaluation of Interferon Alpha (IFN-α) in Women with Systemic Lupus Erythematosus in Iraq

     Systemic Lupus Erythematosus (SLE) is a multifactorial chronic systemic autoimmune disease. It is characterized by a lack of immune tolerance to autoantigens such as nuclear antigens. The aim of the study is to assess the interferon-alpha (IFN-α) serum level in Iraqi patients with SLE and determine its potential relation to different clinical and laboratory parameters and disease activity. 100 SLE patients were all females and with a mean of age 31.3 ± 10 years (16-63years) and disease duration of 5.8 ± 3.7years (1 month to 15 years). The average of SLEDAI score ranged from 2 to 22 with a mean of (8.53 ±3.42). Proteinuria, ESR, creatinine and AST were significantly higher (65% vs. 10% and 0.62±0.11 vs. 0.70±0.14 mg/dl resp

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Publication Date
Sun Sep 01 2019
Journal Name
Journal Of Physics: Conference Series
Autoantibody Profile in Systemic Lupus Erythematosus Patients
Abstract<p>Systemic lupus erythematosus (SLE) is an autoimmune disease, in which the etiology is not well-understood; however, interactions between environmental and genetic factors in predisposed individuals have been recognized. As a consequence, immunological alternations occur and immune cells are involved, especially T and B lymphocytes that are activated to produce different immune components. Among these components are autoantibodies that react with self-antigens aside from non-self-antigens due to the proposed theory of molecular mimicry. Accordingly, the current study was designed to examine the profile of different autoantibodies in SLE patients by using the indirect membrane based enzyme immunoassay </p> ... Show More
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Assessment of miR-146a Gene Polymorphisms in Patients with Systemic Lupus Erythematosus

      Systemic lupus erythematosus (SLE) is a multifactorial chronic autoimmune disease, with a wide spectrum of effect. The main feature of the disease is the production of a wide variety of autoantibodies as a result of immune tolerance loss. The work aims to evaluate the miRNA-146a gene polymorphism potential association with disease activity and chronicity changes in SLE patients. The study included 100 SLE patients and 50 matched controls. The systemic lupus erythematosus disease activity index (SLEDAI) was assessed. The single nucleotide polymorphism (SNP) of miR-146a gene (rs2910164) polymorphism was assayed by polymerase chain reaction (PCR) and sequencing technique in patients and control. 100 SLE pati

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Publication Date
Wed Nov 13 2019
Journal Name
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Migraine In Systemic Lupus Erythematosus in Rheumatological outpatients unit

Background: Migraine is common in systemic lupus erythematosus.It is a significant source of patient disability.

Objective: To determine the rate of migraine in patients with systemic lupus erythematosus, to assess migraine type, severity, and the association between migraine and patient’s characteristics.

Type of the study: Cross-sectional study.

Methods: 100 subjected were recruited and divided into two groups; fifty patients with the diagnosis of systemic lupus erythematosus were recruited from the Rheumatologic department of medicine,and another 50 normal subjects, then complete medical and drugs history were taken from them.

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Publication Date
Wed Aug 30 2023
Journal Name
Iraqi Journal Of Science
The Impact of Some Biochemical Factors in Increasing Disease Pathogenicity of Systemic Lupus Erythematosus

     Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease with unknown etiology, though genetic and environmental factors appear to play a role in its pathogenesis. In particular, infectious processes are linked to the onset and exacerbation of SLE. The aim of the current study was to understand the relationship between some biochemical factors in SLE patients. 105 blood samples from both genders were collected.  ELISA technique was used for detecting specific procalcitonin, vitamin D and calcium. The results of this study showed that SLE patients recorded the lowest percentages of calcium (7.36 ± 0.10 mg/dl) than control (11.97 ± 2.12 mg/dl), and vitamin D (7.79 ± 0.58 pg/ml) than control (22.10 ± 4.8

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Publication Date
Sun Jan 03 2010
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Correlation between Interleukin-4 and Interleukin-6 and auto antibodies in Systemic Lupus Erythematosus.

Background: There is a general acceptance which illustrated that auto antibodies act as a central immunological disturbance in most of the auto immune diseases, among these auto immune diseaselies the SLE
Patients and Methods: Thirty five patients with SLE were compared to twenty age and sex matched, control subjects and studied for the presence of auto antibodies, plus IL-4 and IL-6 using Elisa method and immune fluorescent method (for ANA only)
Results: Data showed that IL-6 detectable levels were statistically significant in patients with positive anti ds-DNA, but not significant statistically in ANA positive patients although it was detected in 24 (70.6%) of positive ANA patients, while there was no sta

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Publication Date
Sat Feb 01 2020
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A Case Report of a Late-Onset Systemic Lupus Erythematosus Like- Induced by Carbamazepine Therapy

A case of systemic lupus erythematosus like induced by carbamazepine therapy in a 27 year old female patient with left sided trigeminal neuralgia had been recorded, 9 years from starting carbamazepine therapy. The patient condition improved clinically 3 days after withdrawal of
carbamazepine , the titer of antinuclear antibodies dropped from 1/640 to 1/80 after 3 weeks, and disappear completely after 6 months follow up.

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Publication Date
Fri Sep 01 2023
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The Medical Journal Of Malaysia
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Sun Jan 01 2023
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Evaluation of Interleukin-9 Serum Level and Gene Polymorphism in A Sample of Systemic Lupus Erythematosus in Iraqi Female's Patients.

Background Immunological gene and serum level for interleukin- 9 rs 17317275 have been established to have linked to predisposition systemic lupus erythematosus (SLE) and its severity. SLE is a severe, systemic autoimmune disease characterized by autoantibody generation, complement activation, and immune complex deposition. In the pathophysiology of SLE, cytokines have a pleiotropic function. Recently, IL-9 was discovered to mediate strong anti-inflammatory effects in numerous cells or experimental autoimmune models. Objective This study aimed to determine the role of age, IL-9 serum level and genetic polymorphism, C-reactive protein (CRP), Anti-nuclear antibody (ANA) and Anti- double-stranded DNA (anti-dsDNA) to recognize SLE pathogenesis.

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