Neuropsychiatric Symptomatology in Systemic Lupus Patients

Overview

The aim of the study was to evaluate significant differences among the various types of central nervous system (CNS) affection in patients with systemic lupus erythematosus (SLE) with neuropsychiatric manifestation (NPSLE). The clinical findings of 70 patients with diagnosis of SLE with neuropsychiatric symptomatology were prospectively recorded and compared with activity indices and findings of other auxiliary methods. NPSLE patients have the focal hyperintensities in the white matter on MR findings in the T2 weighted images. The lesions mainly reach the size up to 3 mm and they are localized predominantly in frontal and parietal regions of both hemispheres. These signal changes are supposed to be caused by the vasculopathy or vasculitis of cerebral arterioles with microthrombosis and gliosis. Cerebrospinal fluid (CSF) analysis is nonspecific; it shows the blood brain barrier (BBB) disruption more precisely than postcontrast MR scans, being present in up to 50% of patients. Postcontrast MRI scans are influenced by corticotherapy and therefore need not show signal changes. We did not find any specific changes in paraclinical investigations caused by various types of neuropsychiatric symptomatology. There was no correlation between them and the activity of the disease.

Key words:
systemic lupus erythematosus, clinical types, auxilliary methods.