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- Title
Diagnosing and attributing neuropsychiatrie events to systemic lupus erythematosus: time to untie the Gordian knot?
- Authors
Sen Hee Tay; Mak, Anselm
- Abstract
Neurological and psychiatric syndromes, collectively referred to as NPSLE, occur frequently in SLE. The (frequency of NPSLE varies from 21 to 95%; however, only 13-38% of neuropsychiatric (NP) events could be attributable to SLE in the NPSLE SLICC inception cohort. This variability in the frequency of NPSLE is attributable to the low specificity of the ACR case definitions for SLE-attributed NP syndromes, inclusion of minor NP events in the ACR nomenclature, difficulty in ascertainment of NP events and diverse experience of rheumatologists in the clinical assessment of NP events. Making the correct and early attribution of NP events to SLE is important to institute appropriate immunosuppressive treatment for favourable outcomes. Various attribution models using composite decision rules have been developed and used to ascribe NP events to SLE. This review will focus on the various clinical presentations, diagnostic work-up and attributions of the common NPSLE syndromes, including other NP events not included in the ACR nomenclature but which have come to attention in recent years.
- Subjects
CEREBROVASCULAR disease diagnosis; MENINGITIS diagnosis; SEIZURES (Medicine); DEMYELINATION; ENCEPHALITIS; MOVEMENT disorders; PERIPHERAL neuropathy; NEUROLOGICAL disorders; PSYCHOSES; RHEUMATOLOGY; SPASMS; SPINAL cord diseases; SYSTEMIC lupus erythematosus; ANXIETY disorders; PSYCHIATRIC treatment; DISEASE complications
- Publication
Rheumatology, 2017, Vol 56, pi14
- ISSN
1462-0324
- Publication type
Article
- DOI
10.1093/rheumatology/kew338