J M Pego-Reigosa1, D A Isenberg. 1. Centre for Rheumatology Research, University College of London Division of Medicine, London, UK. jose.maria.pego.reigosa@sergas.es
Abstract
OBJECTIVE: To determine the prevalence, characteristics and long-term outcome of psychosis due to SLE defined according to the ACR nomenclature for neuropsychiatric (NP) syndromes. METHODS: All the patients who strictly fulfilled the ACR definition for psychosis due to lupus were identified within the 485 patients of our lupus cohort and retrospectively evaluated. RESULTS: Psychosis due to lupus was diagnosed in 11 (2.3%) patients. Lupus psychosis presented as the initial presentation of SLE in 60% of the patients and within the first year of the disease in 80% of the cases. All the patients developed psychotic symptoms within the context of multi-systemic lupus activity, with 90% of them having cutaneous involvement. Psychosis activity in our patients was associated with biological markers of lupus activity in 90% of the cases. The aPLS were observed in 10% of the cases. Seventy percent of our patients showed complete resolution of psychotic symptoms after a mean follow-up of 155 months. Long-lasting remissions were seen in all those patients. Chronic mild psychotic symptoms were observed in 30% of our patients. CONCLUSION: Psychosis due to lupus is an uncommon event that usually occurs early in the course of the disease and is associated with other clinical and biological features of SLE. Long-term outcome appears to be favourable after intensive immunosuppressive treatment. This report highlights the need for prospective multi-centre studies to improve our knowledge and to help establish guidelines for the treatment of this rare complication of lupus.
OBJECTIVE: To determine the prevalence, characteristics and long-term outcome of psychosis due to SLE defined according to the ACR nomenclature for neuropsychiatric (NP) syndromes. METHODS: All the patients who strictly fulfilled the ACR definition for psychosis due to lupus were identified within the 485 patients of our lupus cohort and retrospectively evaluated. RESULTS:Psychosis due to lupus was diagnosed in 11 (2.3%) patients. Lupus psychosis presented as the initial presentation of SLE in 60% of the patients and within the first year of the disease in 80% of the cases. All the patients developed psychotic symptoms within the context of multi-systemic lupus activity, with 90% of them having cutaneous involvement. Psychosis activity in our patients was associated with biological markers of lupus activity in 90% of the cases. The aPLS were observed in 10% of the cases. Seventy percent of our patients showed complete resolution of psychotic symptoms after a mean follow-up of 155 months. Long-lasting remissions were seen in all those patients. Chronic mild psychotic symptoms were observed in 30% of our patients. CONCLUSION:Psychosis due to lupus is an uncommon event that usually occurs early in the course of the disease and is associated with other clinical and biological features of SLE. Long-term outcome appears to be favourable after intensive immunosuppressive treatment. This report highlights the need for prospective multi-centre studies to improve our knowledge and to help establish guidelines for the treatment of this rare complication of lupus.
Authors: Essam A Abda; Zahraa I Selim; Moustafa E M Radwan; Nagham M Mahmoud; Omar M Herdan; Khalid A Mohamad; Sherifa A Hamed Journal: Rheumatol Int Date: 2012-10-12 Impact factor: 2.631