Neuropsychiatric lupus in patients with lupus glomerulonephritis.

Neuropsychiatric symptoms are recognized to occur in a significant percentage of systemic lupus erythematosus patients and to be a leading cause of morbidity and mortality in lupus. The aim of the present study is to investigate neuropsychiatric symptoms in the patients with lupus nephritis without chronic renal failure. We studied 74 patients (4 male, 70 female) with SLE without chronic renal failure. Disease activity was assessed by the European Consensus Lupus activity Measurement (ECLAM). Renal biopsies disclosed type V lesions in 23 patients, type IV--in 34, type III--in 3, type II--in 11, type I--in 3 patients. Two control groups are used--with rheumatoid arthritis (96 patients) and 63 healthy subjects. The most frequent clinical manifestations are cognitive dysfunction (52.94%), headache (29.41%), psychoses (17.65%), epileptic seizures (20.59%) etc., and the most common cognitive deficit is related to impairment of the memory. The tests for cognitive disorders and nuclear magnetic resonance are the methods of investigation, by which the nervous system injuries are most early detected in the course of the disease. The presented study describes the correlations between the immunologic deviations (antiribosomal P-antibodies, aPL, aSm, aC1q), MMP-9, AT III and the NP injuries.