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Risk factors for neuropsychiatric manifestations in children with systemic lupus erythematosus: case-control study

Yenny Carolina Zuniga Zambrano1, Juan David Guevara Ramos2, Nathalia Elena Penagos Vargas1

  • 1Pediatric Neurology Program, Department of Pediatrics, National University of Colombia, Colombia.

Pediatric Neurology
|August 28, 2014
PubMed

Insights

Lupus anticoagulant is a risk factor for neuropsychiatric symptoms in children with systemic lupus erythematosus. Immunosuppressants like cyclophosphamide, rituximab, and azathioprine delay symptom onset in these pediatric patients.

Area of Science:

  • Pediatric Rheumatology
  • Pediatric Neurology
  • Immunology

Background:

  • Neuropsychiatric symptoms significantly impact children with systemic lupus erythematosus (SLE), leading to high morbidity and disability.
  • Understanding risk factors for these symptoms is crucial for early intervention and improved patient outcomes.

Purpose of the Study:

  • To analyze risk factors associated with neuropsychiatric (NP) presentation in pediatric patients (<18 years) diagnosed with systemic lupus erythematosus (SLE).

Main Methods:

  • A case-control study was conducted using medical records of SLE patients hospitalized between March 2007 and January 2012.
  • Clinical variables, laboratory data, neuroimages, and disease activity/damage indices (SLEDAI, SLICC) were analyzed.
  • Patients were categorized based on the presence or absence of neuropsychiatric symptoms.

Main Results:

  • Of 90 pediatric SLE patients, 30 presented with NP symptoms (e.g., seizures, migraine, depression).
  • Higher SLEDAI and SLICC scores, elevated complement C3/C4 levels, and presence of lupus anticoagulant (OR 3.7) were associated with NP symptoms.
  • Immunosuppressive therapy (azathioprine, rituximab, cyclophosphamide) delayed NP manifestation by 18.5 months.

Conclusions:

  • Lupus anticoagulant is identified as a significant risk factor for neuropsychiatric manifestations in pediatric SLE.
  • The use of specific immunosuppressants demonstrates a protective effect by delaying the onset of these debilitating symptoms.
Abstract

Keywords:
adolescentscase-control studychildrenneuropsychiatric systemic lupus erythematosussystemic lupus erythematosus

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