Neuropsychiatric involvement in pediatric systemic lupus erythematosus

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The bm12 Inducible Model of Systemic Lupus Erythematosus (SLE) in C57BL/6 Mice
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The bm12 Inducible Model of Systemic Lupus Erythematosus (SLE) in C57BL/6 Mice

Published on: November 1, 2015

S M Benseler1, E D Silverman

  • 1Divisions of Rheumatology, Department of Paediatrics and Immunology, The Hospital for Sick Children, University of Toronto, Toronto, Canada.

Lupus
|August 23, 2007
PubMed

Insights

Neuropsychiatric (NP) symptoms affect about 25% of pediatric lupus patients, often within the first year of diagnosis. While outcomes are generally good, some children may experience lasting damage.

Area of Science:

  • Pediatric Rheumatology
  • Pediatric Neurology
  • Immunology

Background:

  • Neuropsychiatric (NP) manifestations affect approximately 25% of children and adolescents with pediatric Systemic Lupus Erythematosus (pSLE).
  • NP involvement frequently occurs within the first year of diagnosis in pediatric lupus patients.
  • Common NP presentations include headaches, psychosis, cognitive dysfunction, and cerebrovascular disease.

Purpose of the Study:

  • To summarize the current understanding of neuropsychiatric manifestations in pediatric SLE.
  • To highlight common clinical presentations and associated factors.
  • To review current treatment approaches and outcomes in NP-pSLE.

Main Methods:

  • Literature review of studies on neuropsychiatric manifestations in pediatric SLE.
  • Analysis of reported clinical presentations, diagnostic considerations, and treatment strategies.
  • Evaluation of patient outcomes, including survival rates and long-term sequelae.

Main Results:

  • Headaches, psychosis, cognitive dysfunction, and cerebrovascular disease are the most frequent NP manifestations in pSLE.
  • Anti-phospholipid antibodies are linked to specific NP conditions like chorea, cerebrovascular disease, and seizures.
  • Standard treatment involves immunosuppressive combination therapy, though prospective studies are lacking.

Conclusions:

  • Neuropsychiatric involvement is a significant concern in pediatric SLE, requiring multidisciplinary management.
  • While overall survival is high, a notable percentage of children experience disease flares and permanent NP damage.
  • Further research into novel auto-antibodies, imaging, and therapies is warranted for improved patient outcomes.

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