TY - JOUR
TI - Predictors of clinical outcome and radiologic progression in patients
with neuropsychiatric manifestations of systemic lupus erythematosus
AU - Karassa, FB
AU - Ioannidis, JPA
AU - Boki, KA
AU - Touloumi, G and
AU - Argyropoulou, MI
AU - Strigaris, KA
AU - Moutsopoulos, HM
JO - AMERICAN JOURNAL OF MEDICINE
PY - 2000
VL - 109
TODO - 8
SP - 628-634
PB - Excerpta Medica Inc.
SN - 0002-9343
TODO - 10.1016/S0002-9343(00)00603-3
TODO - null
TODO - PURPOSE: We sought to identify the predictors of clinical outcome and of
the evolution of cerebral abnormalities in patients with
neuropsychiatric systemic lupus erythematosus (SLE).
SUBJECTS AND METHODS: Thirty-two patients with SLE (including 14 with
the antiphospholipid syndrome) who had been hospitalized with primary
neuropsychiatric disease were observed prospectively for at least 2
years. Laboratory and clinical characteristics and data from magnetic
resonance imaging (MRI) studies obtained during the hospitalization and
2 years later were evaluated. We ascertained nonreversible or new MRI
changes and clinical outcomes, including neuropsychiatric events, during
follow-up.
RESULTS: Cranial MRI scans on admission were abnormal in 26 (81%) of
the 32 patients. Patients with the antiphospholipid syndrome were more
likely to have focal cerebral white matter lesions (odds ratio [OR] =
12, 95% confidence interval [CI]: 2.0 to 72). After 2 years,
neuropsychiatric deficits substantially improved in 22 (69%) of the
patients, stabilized in 6 (19%), and deteriorated in 4 (12%). The
number of prior neuropsychiatric events was associated with persistent
MRI lesions (OR = 4.8 per each event, 95% CI: 1.1 to 21) and
unfavorable clinical outcome (OR = 4.3 per each event, 95% CI: 1.4 to
13) at 2 years. The antiphospholipid syndrome also predicted an
unfavorable clinical outcome at 2 years (OR = Il, 95% CI: 1.7 to 65).
CONCLUSIONS: Among patients with SLE who have neuropsychiatric disease,
prior neuropsychiatric events and the antiphospholipid syndrome increase
the risk of adverse outcomes. (C) 2000 by Excerpta Medica, Inc.
ER -