Neuropsychiatric systemic lupus erythematosus

Rogelio Garcia-Cavazos, Robin Brey

Research output: Chapter in Book/Report/Conference proceedingChapter

3 Scopus citations

Abstract

Definitions And Diagnostic criteria are established for 19 CNS and PNS syndromes cases observed in systemic lupus erythematosus (SLE) patients, which collectively are referred to as neuropsychiatric systemic lupus erythematosus (NPSLE) syndromes. An important consideration in the diagnostic approach to a patient with possible NPSLE manifestations is whether the particular clinical syndrome is due to SLE-mediated organ dysfunction, a secondary phenomenon related to infection, medication side-effects, or metabolic abnormalities (e.g., uremia), or is due to an unrelated condition. For each NPSLE syndrome, the ACR case definitions give a clear guidance regarding the differential diagnosis and evaluation that is required to make a diagnosis of a primary NPSLE syndrome. The presence of discoid and articular manifestations is thought to associate with a more benign course and less likelihood of NPSLE [20], while their absence at onset or during flares seems to bestow a higher risk of CNS involvement, primarily cerebrovascular disease and seizures, and also psychosis, acute confusional state, and isolated cognitive dysfunction. Other associations with high likelihood of NPSLE are low serum levels of C3, and especially C4, high-titer aCL (IgG) antibodies, and cutaneous vasculitic lesions. There is no single diagnostic test sensitive and specific for NPSLE. The assessment of individual patients is based on clinical neurological and rheumatologic evaluation, immunoserologic testing, brain imaging, and psychiatric and neuropsychologic assessment.

Original languageEnglish (US)
Title of host publicationSystemic Lupus Erythematosus
Subtitle of host publicationFourth Edition
PublisherElsevier Inc.
Pages757-783
Number of pages27
ISBN (Print)9780124339019
DOIs
StatePublished - May 2004

ASJC Scopus subject areas

  • Immunology and Microbiology(all)

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