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Neuropsychiatric lupus

Zbigniew Zdrojewski
Recognizing the antiphospholipid syndrome (APS) in patients with lupus (SLE) can be difficult and therefore underestimated. Detection of antiphospholipid antibodies (aPL) in each patient with SLE should be done as a rule. Introduction of the new classification criteria of this syndrome will certainly improve the recognition of APS in the future. The Sapporo APS classification criteria (1998) were replaced by the Sydney criteria in 2006. Based on the most recent criteria, classification with APS requires one clinical and one laboratory manifestation...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Arantzazu Zabala, Monika Salgueiro, Oihane Sáez-Atxukarro, Javier Ballesteros, Guillermo Ruiz-Irastorza, Rafael Segarra
OBJECTIVES: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. Its most prevalent manifestation is neuropsychiatric SLE (NP-SLE), which is characterized by increased involvement of the nervous system, with relevant symptoms, such as marked cognitive deficits, which are directly involved in subsequent functional disability. The objective of this study is to identify and compare the profile of cognitive deficits in patients with NP-SLE and patients with non-neuropsychiatric SLE (nonNP-SLE) by means of a systematic review and meta-analysis...
March 19, 2018: Journal of the International Neuropsychological Society: JINS
Dongyan Shi, Tongguan Tian, Shu Yao, Kelei Cao, Xingxing Zhu, Mingshun Zhang, Shuang Wen, Longjun Li, Meiqing Shi, Hong Zhou
Neuropsychiatric (NP) involvement in systemic lupus erythematosus (SLE) severely impacts patients' quality of life and leads to a poor prognosis. The current therapeutic protocol, corticosteroid administration, can also induce neuropsychiatric disorders. FTY720 is an immunomodulator that selectively confines lymphocytes in lymph nodes and reduces autoreactive T cell recruitment to the central nervous system (CNS). This study aimed to identify a novel therapeutic strategy for NPSLE. B6.MRL-lpr mice were treated with oral administration of FTY720 (2 mg/kg) three times per week for 12 weeks, to evaluate its efficacy in a model of NPSLE...
March 13, 2018: Brain, Behavior, and Immunity
Mari Miyata, Shingo Kakeda, Kohsuke Kudo, Shigeru Iwata, Yoshiya Tanaka, Yi Wang, Yukunori Korogi
The purposes of this study are to assess the oxygen extraction fraction (OEF) changes on MRI-based quantitative susceptibility mapping (QSM) in systemic lupus erythematosus (SLE) patients and to determine whether QSM-OEF is associated with disease activity in SLE. We enrolled 42 SLE patients and 20 healthy subjects (HS) who had no pathologies on conventional brain MRI. Disease activity was assessed using SLE Disease Activity Index (SLEDAI). For the measurement of QSM-OEF, QSM data were analysed using the Perfusion Mismatch Analyzer software program...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
Alicja Kalinowska-Łyszczarz, Mikołaj A Pawlak, Aleksandra Wyciszkiewicz, Katarzyna Pawlak-Buś, Piotr Leszczyński, Mariusz Puszczewicz, Włodzimierz Paprzycki, Wojciech Kozubski, Sławomir Michalak
OBJECTIVE: Central nervous system (CNS) involvement in systemic lupus erythematosus (SLE) remains poorly understood. Damage within the CNS is driven by the autoimmune response; however, immunopathophysiology of neuropsychiatric (NP) SLE is multifactorial. Immune cell neurotrophin production could be neuroprotective against autoimmunity-driven CNS damage, as has been shown in multiple sclerosis. The aim of this study was to establish whether immune cell neurotrophin production is associated with damage severity in NPSLE...
March 14, 2018: Neuroimmunomodulation
Bei-Bei Wu, Ye Ma, Lei Xie, Jin-Zhuang Huang, Zong-Bo Sun, Zhi-Duo Hou, Rui-Wei Guo, Zhi-Rong Lin, Shou-Xing Duan, Shan-Shan Zhao, Yao-Xie, Dan-Miao Sun, Chun-Min Zhu, Shu-Hua Ma
BACKGROUND: Systemic lupus erythematosus (SLE) is associated with cognitive deficit but the exact neural mechanisms remain unclear. PURPOSE: To explore sequential brain activities using functional magnetic resonance imaging (fMRI) during the performance of a decision-making task, and to determine whether serum or clinical markers can reflect the involvement of the brain in SLE. SUBJECTS: Sixteen female SLE patients without overt clinical neuropsychiatric symptoms and 16 healthy controls were included...
March 14, 2018: Journal of Magnetic Resonance Imaging: JMRI
B Cannerfelt, J Nystedt, A Jönsen, J Lätt, D van Westen, A Lilja, A Bengtsson, P Nilsson, J Mårtensson, P C Sundgren
Aim The aim of this study was to evaluate the extent of white matter lesions, atrophy of the hippocampus and corpus callosum, and their correlation with cognitive dysfunction (CD), in patients diagnosed with systemic lupus erythematosus (SLE). Methods Seventy SLE patients and 25 healthy individuals (HIs) were included in the study. To evaluate the different SLE and neuropsychiatric SLE (NPSLE) definition schemes, patients were grouped both according to the American College of Rheumatology (ACR) definition, as well as the more stringent ACR-Systemic Lupus International Collaborating Clinics definition...
January 1, 2018: Lupus
Ami Schattner, Shilo Voichanski, Livnat Uliel
A healthy 38-year-old woman developed sudden unilateral vision loss due to retrobulbar optic neuritis in the wake of varicella-zoster virus infection. She had no further central nervous system (CNS) lesions. Antinuclear antibodies (ANA) and anti-aquaporin 4 antibodies were found, consistent with neuromyelitis optica (NMO). Later, serial MRIs showed dynamic short-segment and long-segment myelitis lesions, ANA titre increased and additional autoantibodies were found including anti-dsDNA, anti-chromatin/nucleosome and antiphospholipid antibodies...
March 5, 2018: BMJ Case Reports
Jessika Nystedt, Peter Mannfolk, Petra Nilsson, Anders Bengtsson, Andreas Jönsen, Pia C Sundgren, Olof Strandberg
PURPOSE: To investigate resting state functional connectivity of lupus-patients and associated subgroups according to the ACR NPSLE case definitions (ACR ad Hoc 1999). Additionally, we investigated whether or not the observed alterations correlated with disease duration, SLE-disease activity index-2000 (SLEDAI-2k) and Systemic Lupus International Collaborating Clinical/ACR organ damage index (SDI)-scores. MATERIAL AND METHOD: Anatomical 3T MRI and resting state-fMRI (rs-fMRI) were performed in 61 female lupus-patients (mean age = 37...
March 2, 2018: Brain Connectivity
Yoshiyuki Arinuma
PURPOSE OF REVIEW: Neuropsychiatric manifestations are one of the fatal complications in patients with systemic lupus erythematosus (SLE). However, the diagnosis and monitoring of that aspect of SLE is still challenging, as there are no reliable biomarkers linked to central nervous system (CNS) damage. This review emphasizes potential candidate autoantibodies that appear to be associated with development of behavioral and psychiatric manifestations in SLE patients. RECENT FINDINGS: Developments in the pathogenesis in SLE, not surprising for this immune disorder, point to specific, autoantibody toxicity...
February 22, 2018: Current Opinion in Neurology
Alfonso González, Loreto Massardo
PURPOSE OF REVIEW: Analysis of antiribosomal P protein autoantibodies (anti-P) pathogenicity in diffuse brain manifestations of neuropsychiatric lupus, emphasizing cognitive dysfunction and the recently emerged role of cross-reacting neuronal surface P antigen (NSPA) in α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid and N-Methyl-D-Aspartate receptor glutamatergic transmission. RECENT FINDINGS: Circulating anti-P antibodies associate with executive planning dysfunction and attention impairments in lupus patients and perturb glutamatergic transmission through NSPA in mice hippocampus, translating into impaired synaptic plasticity and spatial memory...
February 15, 2018: Current Opinion in Neurology
T A Gheita, N M Abaza, N Hammam, A A A Mohamed, I I El-Gazzar, A H Eissa
Background Attempts are ongoing to unveil unresolved queries about anti-double-stranded deoxyribonucleic acid (anti-dsDNA), their precise pathogenic effects and to what extent blocking them would be a useful therapeutic goal. Objectives The aim of the present study was to determine the anti-dsDNA antibodies titre in systemic lupus erythematosus (SLE) patients and investigate their relation to the disease characteristics, activity, damage and antiphospholipid autoantibodies (aPL). Methods Seventy female SLE patients and 35 age- and sex-matched controls were included...
January 1, 2018: Lupus
Shuang Liu, Yuqi Cheng, Yueyin Zhao, Hongjun Yu, Aiyun Lai, Zhaoping Lv, Xiufeng Xu, Chunrong Luo, Baoci Shan, Lin Xu, Jian Xu
The aim of the study was to find structural brain changes in systemic lupus erythematosus patients without major neuropsychiatric manifestations [non-neuropsychiatric systemic lupus erythematosus (non-NPSLE)] using quantitative magnetic resonance imaging (MRI) and possible associations with clinical characteristics. 89 non-NPSLE patients with normal conventional MRI and 84 healthy controls (HCs) were recruited. The whole brain gray matter volume (GMV) and white matter volume (WMV) were calculated for each individual...
2018: Frontiers in Psychiatry
K T El Hadidi, B M Medhat, N M Abdel Baki, H Abdel Kafy, W Abdelrahaman, A Y Yousri, D H Attia, M Eissa, D El Dessouki, I Elgazzar, F T Elgengehy, N El Ghobashy, H El Hadary, G El Mardenly, H El Naggar, A M El Nahas, R M El Refai, H Allah El Rwiny, R M Elsman, M Galal, S Ghoniem, L A Maged, S M Sally, H Naji, S Saad, M Shaaban, M Sharaf, N Sobhy, R M Soliman, T S El Hadidi
Introduction Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that can vary among different ethnic and racial groups. Objective The objective of this paper is to study the prevalence of various manifestations of SLE in a sample of the Egyptian population. Patients and methods Information in this study was derived from the medical records of SLE patients who sought medical advice at a private clinic in Cairo from January 1980 to June 2016. Results This study included 1109 SLE patients, of whom 114 (10...
January 1, 2018: Lupus
Osman Perez, Kairavee Dave, Aimee Almanzar, Tajul Prodhan, Livasky Concepion
Neuropsychiatric systemic lupus erythematosus (NPSLE) has a wide variety of neurologic and psychiatric features. NPSLE symptoms and the psychotic features of primary psychiatric disorders often overlap with each other. These psychotic features often mask and delay the diagnosis of NPSLE. We present the case of a 59-year-old female previously diagnosed with bipolar disorder and generalized anxiety disorder presenting with altered mental status (AMS), subsequently diagnosed with neuropsychiatric lupus. Initially, medication overdose was suspected as an empty bottle of trazodone was found beside her...
October 23, 2017: Curēus
Jessika Nystedt, Markus Nilsson, Andreas Jönsen, Petra Nilsson, Anders Bengtsson, Åsa Lilja, Jimmy Lätt, Peter Mannfolk, Pia C Sundgren
BACKGROUND: The purpose of this study was to investigate whether white matter microstructure is altered in patients suffering from systemic lupus erythematosus (SLE), and if so, whether such alterations differed between patients with and without neuropsychiatric symptoms. METHODS: Structural MRI and diffusion tensor imaging (DTI) were performed in 64 female SLE patients (mean age 36.9 years, range 18.2-52.2 years) and 21 healthy controls (mean age 36.7 years, range 23...
February 7, 2018: Arthritis Research & Therapy
Samantha A Chalmers, Jing Wen, Jessica Doerner, Ariel Stock, Carla M Cuda, Hadijat M Makinde, Harris Perlman, Todd Bosanac, Deborah Webb, Gerald Nabozny, Jay S Fine, Elliott Klein, Meera Ramanujam, Chaim Putterman
BACKGROUND: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that affects different end organs, including skin and brain. We and others have previously shown the importance of macrophages in the pathogenesis of cutaneous and neuropsychiatric lupus. Additionally, autoantibodies produced by autoreactive B cells are thought to play a role in both the skin and central nervous system pathologies associated with SLE. METHODS: We used a novel inhibitor of Bruton's tyrosine kinase (BTK), BI-BTK-1, to target both macrophage and B cell function in the MRL-lpr/lpr murine model of SLE, and examined the effect of treatment on skin and brain disease...
January 25, 2018: Arthritis Research & Therapy
A Flores-Chávez, J A Carrion, X Forns, M Ramos-Casals
Chronic hepatitis C virus (HCV) infection has been associated with both organ-specific and systemic autoimmune diseases, with cryoglobulinemia being the most frequent associated disease. Experimental, virologic, and clinical evidence have demon-strated a close association between HCV infection and some systemic autoimmune diseases, especially Sjögren's syndrome, but also rheumatoid arthritis and lupus. A higher prevalence of hematological processes has also been described in patients with HCV infection, including cytopenias and lymphoproliferative disorders (B-cell lymphoma)...
December 2017: Revista Española de Sanidad Penitenciaria
Efrosini Papadaki, Antonis Fanouriakis, Eleftherios Kavroulakis, Dimitra Karageorgou, Prodromos Sidiropoulos, George Bertsias, Panagiotis Simos, Dimitrios T Boumpas
No abstract text is available yet for this article.
January 23, 2018: Annals of the Rheumatic Diseases
Emre Misir, İbrahim Tolga Binbay, Bilge Targitay, Hidayet Ece Arat, Gerçek Can, Köksal Alptekin
Systemic lupus erythematosus (SLE) or Lupus is a chronic and idiopathic autoimmune connective tissue disease that involves several organs and organ systems. SLE may lead to a group of psychiatric manifestations, including delirium, anxiety disorders, cognitive dysfunction, mood disorders, and psychosis, which are caused by organic or non-organic factors. In addition, it is thought that the most common cause of neuropsychiatric lupus is corticosteroid use; central nervous system involvement and inflammatory processes also have an important role in the development of psychiatric manifestations...
December 2017: Noro Psikiyatri Arsivi
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