Clinical indicators predisposing individuals to neuropsychiatric events in systemic lupus erythematosus: A 7-year retrospective review from a tertiary hospital

全身性紅斑狼瘡發生神經精神表現的可能臨床相關因子：三級醫學中心的七年回溯性研究

陳曉靜(Hsiao-Ching Chen) ； 陳金順(Jin-Shuen Chen) ； 方乃文(Nai-Wen Fang) ； 尹君豪(Chun-Hao Yin) ； 農寶仁(Bao-Ren Nong) ； 呂聆音(Ling-Ying Lu) ； 邱益煊(Yee-Hsuan Chiou)

《Formosan Journal of Rheumatology》 36卷2期 (2022/12) Pp. 1-10

https://doi.org/10.6313/FJR.202212_36(2).0001

摘要

Objective: Our study aimed to identify and compare the associated clinical factors in systemic lupus erythematosus (SLE) patients with and without neuropsychiatric (NP) symptoms, both at the time of new SLE diagnosis and NP event onset. Methods: The data of patients from a tertiary center in Taiwan between January 2013 and April 2020 were reviewed, and patients with a new SLE diagnosis and regular follow-up data were enrolled. Patients who developed NP events during the study period were classified into the NPSLE group, whereas those who did not develop NP events were classified into the non-NPSLE group. Data on clinical manifestations, SLE disease activity index (SLEDAI) score, and laboratory findings were collected at the time of new SLE diagnosis and NP event development. Results: Of 121 patients with a new SLE diagnosis, 22 patients had NPSLE, and 99 patients had non-NPSLE. At the time of diagnosis, SLEDAI scores, clinical presentations, and laboratory results exhibited no significant differences between the two groups. However, at the time of NP event onset, the NPSLE group exhibited lower hemoglobin, platelet, C3, and C4 levels and higher glutamic pyruvic transaminase (GPT) and creatinine (Cr) levels. Conclusions: Our study results suggest that female patients with SLE exhibiting a lower C4 level and higher Cr and GPT levels are more likely to develop NP events. However, further studies are required to establish reliable clinical predictors of NPSLE.

關鍵字

systemic lupus erythematosus ； neuropsychiatry ； autoantibody ； seizure

並列摘要

目的：本篇研究宗旨在辨識及比較有合併及無合併神經精神（NP）症狀的系統性紅斑狼瘡（SLE）患者之不同臨床特徵，並評估這兩個族群在初診斷時和發生NP事件時的相關臨床因子。方法：本研究資料來自台灣一所三級醫學中心，收錄了2013年1月至2020年4月於本院診斷為SLE並定期追蹤的患者。在研究期間發生NP事件的患者被歸類為NPSLE組，反之為非NPSLE組。在兩組中，比較初診斷SLE時和NP事件發生時的臨床表現、SLE疾病活動指數（SLEDAI）評分和實驗室檢查結果。結果：在121名SLE患者中，22名是NPSLE，99名是非NPSLE。在初診斷時，SLEDAI、臨床表現和實驗室結果顯示兩組之間沒有顯著差異。然而，在發生NP事件期間，NPSLE組有較低的血紅蛋白（Hgb）、較低的血小板（PLT）、較高的丙胺酸轉胺（GPT）、較高的肌酐酸（Cr）以及較低的C3和C4。結論：本研究顯示C4下降、Cr和GPT升高的女性SLE患者更容易發生NP事件。未來仍需要進一步的研究來建立可靠的NPSLE臨床預測因子。

並列關鍵字

系統性紅斑狼瘡 ； 神經精神 ； 自體抗體 ； 癲癇