Neuropsychiatric involvement in juvenile-onset systemic lupus erythematosus: Data from the UK Juvenile-onset systemic lupus erythematosus cohort study

UK JSLE Cohort Study; Teresa Giani; Eve MD Smith; Eslam Al-Abadi; Kate Armon; Kathryn Bailey; Coziana Ciurtin; Joyce Davidson; Janet Gardner-Medwin; Kirsty Haslam; Dan P Hawley; Alice Leahy; Valentina Leone; Flora McErlane; Devesh Mewar; Gita Modgil; Robert Moots; Clarissa Pilkington; Francesca Pregnolato; Athimalaipet V Ramanan; Satyapal Rangaraj; Phil Riley; Arani Sridhar; Nick Wilkinson; Rolando Cimaz; Michael W Beresford; Christian M Hedrich

doi:10.1177/09612033211045050

Neuropsychiatric involvement in juvenile-onset systemic lupus erythematosus: Data from the UK Juvenile-onset systemic lupus erythematosus cohort study

UK JSLE Cohort Study, Teresa Giani^*, Eve MD Smith, Eslam Al-Abadi, Kate Armon, Kathryn Bailey, Coziana Ciurtin, Joyce Davidson, Janet Gardner-Medwin, Kirsty Haslam, Dan P Hawley, Alice Leahy, Valentina Leone, Flora McErlane, Devesh Mewar, Gita Modgil, Robert Moots, Clarissa Pilkington, Francesca Pregnolato, Athimalaipet V RamananSatyapal Rangaraj, Phil Riley, Arani Sridhar, Nick Wilkinson, Rolando Cimaz, Michael W Beresford, Christian M Hedrich

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

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Abstract

Introduction:
Juvenile-onset systemic lupus erythematosus (JSLE) is a rare autoimmune/inflammatory disease with significant morbidity and mortality. Neuropsychiatric (NP) involvement is a severe complication, encompassing a heterogeneous range of neurological and psychiatric manifestations.

Methods:
Demographic, clinical, and laboratory features of NP-SLE were assessed in participants of the UK JSLE Cohort Study, and compared to patients in the same cohort without NP manifestations.

Results:
A total of 428 JSLE patients were included in this study, 25% of which exhibited NP features, half of them at first visit. Most common neurological symptoms among NP-JSLE patients included headaches (78.5%), mood disorders (48.6%), cognitive impairment (42%), anxiety (23.3%), seizures (19.6%), movement disorders (17.7%), and cerebrovascular disease (14.9%). Peripheral nervous system involvement was recorded in 7% of NP-SLE patients. NP-JSLE patients more frequently exhibited thrombocytopenia (<100 × 109/L) (p = 0.04), higher C-reactive protein levels (p = 0.01), higher global pBILAG score at first visit (p < 0.001), and higher SLICC damage index score at first (p = 0.02) and last (p < 0.001) visit when compared to JSLE patients without NP involvement.

Conclusions:
A significant proportion of JSLE patients experience NP involvement (25%). Juvenile-onset NP-SLE most commonly affects the CNS and is associated with increased overall disease activity and damage.

Original language	English
Pages (from-to)	1955-1965
Number of pages	11
Journal	Lupus
Volume	30
Issue number	12
Early online date	2 Oct 2021
DOIs	https://doi.org/10.1177/09612033211045050
Publication status	Published - Oct 2021

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Publisher Copyright:
© The Author(s) 2021.

Keywords

Adolescent
Child
Cohort Studies
Female
Humans
Lupus Erythematosus, Systemic/complications
Lupus Vasculitis, Central Nervous System/epidemiology
Male
Mental Disorders/etiology
United Kingdom/epidemiology

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UK JSLE Cohort Study, Giani, T., Smith, E. MD., Al-Abadi, E., Armon, K., Bailey, K., Ciurtin, C., Davidson, J., Gardner-Medwin, J., Haslam, K., Hawley, D. P., Leahy, A., Leone, V., McErlane, F., Mewar, D., Modgil, G., Moots, R., Pilkington, C., Pregnolato, F., ... Hedrich, C. M. (2021). Neuropsychiatric involvement in juvenile-onset systemic lupus erythematosus: Data from the UK Juvenile-onset systemic lupus erythematosus cohort study. Lupus, 30(12), 1955-1965. https://doi.org/10.1177/09612033211045050

@article{2a6d9ea8c771400e86ac236ceb411eac,

title = "Neuropsychiatric involvement in juvenile-onset systemic lupus erythematosus: Data from the UK Juvenile-onset systemic lupus erythematosus cohort study",

abstract = "Introduction:Juvenile-onset systemic lupus erythematosus (JSLE) is a rare autoimmune/inflammatory disease with significant morbidity and mortality. Neuropsychiatric (NP) involvement is a severe complication, encompassing a heterogeneous range of neurological and psychiatric manifestations.Methods:Demographic, clinical, and laboratory features of NP-SLE were assessed in participants of the UK JSLE Cohort Study, and compared to patients in the same cohort without NP manifestations.Results:A total of 428 JSLE patients were included in this study, 25% of which exhibited NP features, half of them at first visit. Most common neurological symptoms among NP-JSLE patients included headaches (78.5%), mood disorders (48.6%), cognitive impairment (42%), anxiety (23.3%), seizures (19.6%), movement disorders (17.7%), and cerebrovascular disease (14.9%). Peripheral nervous system involvement was recorded in 7% of NP-SLE patients. NP-JSLE patients more frequently exhibited thrombocytopenia (<100 × 109/L) (p = 0.04), higher C-reactive protein levels (p = 0.01), higher global pBILAG score at first visit (p < 0.001), and higher SLICC damage index score at first (p = 0.02) and last (p < 0.001) visit when compared to JSLE patients without NP involvement.Conclusions:A significant proportion of JSLE patients experience NP involvement (25%). Juvenile-onset NP-SLE most commonly affects the CNS and is associated with increased overall disease activity and damage.",

keywords = "Adolescent, Child, Cohort Studies, Female, Humans, Lupus Erythematosus, Systemic/complications, Lupus Vasculitis, Central Nervous System/epidemiology, Male, Mental Disorders/etiology, United Kingdom/epidemiology",

author = "{UK JSLE Cohort Study} and Teresa Giani and Smith, {Eve MD} and Eslam Al-Abadi and Kate Armon and Kathryn Bailey and Coziana Ciurtin and Joyce Davidson and Janet Gardner-Medwin and Kirsty Haslam and Hawley, {Dan P} and Alice Leahy and Valentina Leone and Flora McErlane and Devesh Mewar and Gita Modgil and Robert Moots and Clarissa Pilkington and Francesca Pregnolato and Ramanan, {Athimalaipet V} and Satyapal Rangaraj and Phil Riley and Arani Sridhar and Nick Wilkinson and Rolando Cimaz and Beresford, {Michael W} and Hedrich, {Christian M}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2021.",

year = "2021",

month = oct,

doi = "10.1177/09612033211045050",

language = "English",

volume = "30",

pages = "1955--1965",

journal = "Lupus",

issn = "0961-2033",

publisher = "SAGE Publications Ltd",

number = "12",

}

UK JSLE Cohort Study, Giani, T, Smith, EMD, Al-Abadi, E, Armon, K, Bailey, K, Ciurtin, C, Davidson, J, Gardner-Medwin, J, Haslam, K, Hawley, DP, Leahy, A, Leone, V, McErlane, F, Mewar, D, Modgil, G, Moots, R, Pilkington, C, Pregnolato, F, Ramanan, AV, Rangaraj, S, Riley, P, Sridhar, A, Wilkinson, N, Cimaz, R, Beresford, MW & Hedrich, CM 2021, 'Neuropsychiatric involvement in juvenile-onset systemic lupus erythematosus: Data from the UK Juvenile-onset systemic lupus erythematosus cohort study', Lupus, vol. 30, no. 12, pp. 1955-1965. https://doi.org/10.1177/09612033211045050

TY - JOUR

T1 - Neuropsychiatric involvement in juvenile-onset systemic lupus erythematosus

T2 - Data from the UK Juvenile-onset systemic lupus erythematosus cohort study

AU - UK JSLE Cohort Study

AU - Giani, Teresa

AU - Smith, Eve MD

AU - Al-Abadi, Eslam

AU - Armon, Kate

AU - Bailey, Kathryn

AU - Ciurtin, Coziana

AU - Davidson, Joyce

AU - Gardner-Medwin, Janet

AU - Haslam, Kirsty

AU - Hawley, Dan P

AU - Leahy, Alice

AU - Leone, Valentina

AU - McErlane, Flora

AU - Mewar, Devesh

AU - Modgil, Gita

AU - Moots, Robert

AU - Pilkington, Clarissa

AU - Pregnolato, Francesca

AU - Ramanan, Athimalaipet V

AU - Rangaraj, Satyapal

AU - Riley, Phil

AU - Sridhar, Arani

AU - Wilkinson, Nick

AU - Cimaz, Rolando

AU - Beresford, Michael W

AU - Hedrich, Christian M

PY - 2021/10

Y1 - 2021/10

N2 - Introduction:Juvenile-onset systemic lupus erythematosus (JSLE) is a rare autoimmune/inflammatory disease with significant morbidity and mortality. Neuropsychiatric (NP) involvement is a severe complication, encompassing a heterogeneous range of neurological and psychiatric manifestations.Methods:Demographic, clinical, and laboratory features of NP-SLE were assessed in participants of the UK JSLE Cohort Study, and compared to patients in the same cohort without NP manifestations.Results:A total of 428 JSLE patients were included in this study, 25% of which exhibited NP features, half of them at first visit. Most common neurological symptoms among NP-JSLE patients included headaches (78.5%), mood disorders (48.6%), cognitive impairment (42%), anxiety (23.3%), seizures (19.6%), movement disorders (17.7%), and cerebrovascular disease (14.9%). Peripheral nervous system involvement was recorded in 7% of NP-SLE patients. NP-JSLE patients more frequently exhibited thrombocytopenia (<100 × 109/L) (p = 0.04), higher C-reactive protein levels (p = 0.01), higher global pBILAG score at first visit (p < 0.001), and higher SLICC damage index score at first (p = 0.02) and last (p < 0.001) visit when compared to JSLE patients without NP involvement.Conclusions:A significant proportion of JSLE patients experience NP involvement (25%). Juvenile-onset NP-SLE most commonly affects the CNS and is associated with increased overall disease activity and damage.

AB - Introduction:Juvenile-onset systemic lupus erythematosus (JSLE) is a rare autoimmune/inflammatory disease with significant morbidity and mortality. Neuropsychiatric (NP) involvement is a severe complication, encompassing a heterogeneous range of neurological and psychiatric manifestations.Methods:Demographic, clinical, and laboratory features of NP-SLE were assessed in participants of the UK JSLE Cohort Study, and compared to patients in the same cohort without NP manifestations.Results:A total of 428 JSLE patients were included in this study, 25% of which exhibited NP features, half of them at first visit. Most common neurological symptoms among NP-JSLE patients included headaches (78.5%), mood disorders (48.6%), cognitive impairment (42%), anxiety (23.3%), seizures (19.6%), movement disorders (17.7%), and cerebrovascular disease (14.9%). Peripheral nervous system involvement was recorded in 7% of NP-SLE patients. NP-JSLE patients more frequently exhibited thrombocytopenia (<100 × 109/L) (p = 0.04), higher C-reactive protein levels (p = 0.01), higher global pBILAG score at first visit (p < 0.001), and higher SLICC damage index score at first (p = 0.02) and last (p < 0.001) visit when compared to JSLE patients without NP involvement.Conclusions:A significant proportion of JSLE patients experience NP involvement (25%). Juvenile-onset NP-SLE most commonly affects the CNS and is associated with increased overall disease activity and damage.

KW - Adolescent

KW - Child

KW - Cohort Studies

KW - Female

KW - Humans

KW - Lupus Erythematosus, Systemic/complications

KW - Lupus Vasculitis, Central Nervous System/epidemiology

KW - Male

KW - Mental Disorders/etiology

KW - United Kingdom/epidemiology

U2 - 10.1177/09612033211045050

DO - 10.1177/09612033211045050

M3 - Article (Academic Journal)

C2 - 34601989

SN - 0961-2033

VL - 30

SP - 1955

EP - 1965

JO - Lupus

JF - Lupus

IS - 12

ER -

Neuropsychiatric involvement in juvenile-onset systemic lupus erythematosus: Data from the UK Juvenile-onset systemic lupus erythematosus cohort study

Abstract

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Keywords

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