Resumo

CENTURION-WENNINGER, Claudia. Neuropsychiatric lupus. Rev. parag. reumatol. [online]. 2021, vol.7, n.2, pp.41-48. ISSN 2413-4341.  https://doi.org/10.18004/rpr/2021.07.02.41.

The diagnosis of neuropsychiatric lupus is based on the ACR 1999 nomenclature and case description. However, nonspecific clinical syndromes and diagnostic methods without specific patterns determine a large discrepancy in the reported frequency (14%-75%). A longitudinal, descriptive, observational design was applied based on the evaluation of clinical histories, SLE damage and activity indexes using the SLICC/ACR-DI and SLEDAI-2K, respectively, functional disability using the HAQ and self-reported work disability at 30 days. The number of deaths at one month of follow-up was also recorded. Serum IL-6 was measured at the time of diagnosis, as established by How criteria. Ten cases were described. Four patients debuted with neuropsychiatric involvement. The most frequent syndrome was major depression (n=4), followed by psychosis, seizures, peripheral neuropathy (n=3), stroke and myelitis (n=1). Half the patients (n=5) presented more than one neuropsychiatric diagnosis. The average SLE activity score measured by SLEDAI-2K was 16.5. The average chronic damage score measured by SLICC/ACR-DI was 3. Half the patients scored 2 on the HAQ (n=5) and self-reported work disability at 30-day follow-up was observed in 40% of patients. IL-6 was not detected in plasma, except in one patient with diffuse and focal involvement (value:1.16 pg/ml, reference range in healthy adults: 0-5 pg/ml). No deaths were recorded in the 30-day follow-up after hospital discharge in the study population. Despite having a small number of patients, this case series represents the first in-depth study of patients with SLE and neuropsychiatric involvement. Collaborative studies are needed to include more patients to reliably assess clinical features and possible biomarkers.

Palavras-chave : neuropsychiatric lupus; SLEDAI; SLICC/ACR-DI..

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