Outcome of neuropsychiatric systemic lupus erythematosus within a defined Swedish population:: increased morbidity but low mortality

被引:83
作者
Jönsen, A [1 ]
Bengtsson, AA
Nived, O
Ryberg, B
Sturfelt, G
机构
[1] Univ Lund Hosp, Dept Rheumatol, S-22185 Lund, Sweden
[2] Univ Lund Hosp, Dept Neurol, S-22185 Lund, Sweden
关键词
SLE; SLICC/ACR Damage Index; damage; neuropsychiatric; NPSLE; outcome; mortality; working incapacity; morbidity; disability;
D O I
10.1093/rheumatology/41.11.1308
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. To investigate the outcome of neuropsychiatric involvement in systemic lupus erythematosus patients (NPSLE) recruited from a defined population. Methods. All cases of adult SLE diagnosed during 1981-1995 within the Lund-Orup Health Care District were followed prospectively and neuropsychiatric manifestations were recorded. The SLICC/ACR (Systemic Lupus International Collaborating Clinics/American College of Rheumatology) Damage Index, mortality and working incapacity were recorded as measures of outcome. Results. NPSLE manifestations developed in 38% (44/117) of the patients. A high rate of organ damage (SLICC/ACR Damage Index) was recorded in the NPSLE patients (P<0.001). Compared with patients without neuropsychiatric involvement, NPSLE patients were treated more intensively, with glucocorticoids (P<0.01) and cytostatic drugs (P<0.01). When compared with the normal population in the same area, the NPSLE patients had a higher rate of working incapacity (relative risk 4.0, 95% confidence interval 2.06-6.96), whereas mortality was not increased (standardized mortality rate 1.4, 95% confidence interval 0.5-3.0). Conclusions. SLE patients with neuropsychiatric involvement have an increased rate of organ damage and a high degree of working incapacity, which illustrates the severity of disease in this subgroup.
引用
收藏
页码:1308 / 1312
页数:5
相关论文
共 18 条
[1]   THE NEUROPSYCHIATRIC MANIFESTATIONS OF SYSTEMIC LUPUS-ERYTHEMATOSUS - AN OVERVIEW [J].
ADELMAN, DC ;
SALTIEL, E ;
KLINENBERG, JR .
SEMINARS IN ARTHRITIS AND RHEUMATISM, 1986, 15 (03) :185-199
[2]   NEUROPSYCHIATRIC MANIFESTATIONS OF SYSTEMIC LUPUS-ERYTHEMATOSUS [J].
CALABRESE, LV ;
STERN, TA .
PSYCHOSOMATICS, 1995, 36 (04) :344-359
[3]   The development and initial validation of the systemic lupus international collaborating clinics American College of Rheumatology Damage Index for Systemic Lupus Erythematosus [J].
Gladman, D ;
Ginzler, E ;
Goldsmith, C ;
Fortin, P ;
Liang, M ;
Urowitz, M ;
Bacon, P ;
Bombardieri, S ;
Hanly, J ;
Hay, E ;
Isenberg, D ;
Jones, J ;
Kalunian, K ;
Maddison, P ;
Nived, O ;
Petri, M ;
Richter, M ;
SanchezGuerrero, J ;
Snaith, M ;
Sturfelt, G ;
Symmons, D ;
Zoma, A .
ARTHRITIS AND RHEUMATISM, 1996, 39 (03) :363-369
[4]   OUTCOME OF SYSTEMIC LUPUS-ERYTHEMATOSUS - A STUDY OF 66 PATIENTS OVER 7 YEARS WITH SPECIAL REFERENCE TO THE PREDICTIVE VALUE OF ANTI-DNA ANTIBODY DETERMINATIONS [J].
GRIPENBERG, M ;
HELVE, T .
SCANDINAVIAN JOURNAL OF RHEUMATOLOGY, 1991, 20 (02) :104-109
[5]   ANTINEURONAL ANTIBODIES IN NEUROPSYCHIATRIC SYSTEMIC LUPUS-ERYTHEMATOSUS [J].
HOW, A ;
DENT, PB ;
LIAO, SK ;
DENBURG, JA .
ARTHRITIS AND RHEUMATISM, 1985, 28 (07) :789-795
[6]  
JONSSON H, 1990, BRIT J RHEUMATOL, V29, P185
[7]   OUTCOME IN SYSTEMIC LUPUS-ERYTHEMATOSUS - A PROSPECTIVE-STUDY OF PATIENTS FROM A DEFINED POPULATION [J].
JONSSON, H ;
NIVED, O ;
STURFELT, G .
MEDICINE, 1989, 68 (03) :141-150
[8]  
Liang MH, 1999, ARTHRITIS RHEUM-US, V42, P599
[9]   Psychiatric disorders among subjects with systemic lupus erythematosus in an unselected population [J].
Lindal, E ;
Thorlacius, S ;
Steinsson, K ;
Stefansson, JG .
SCANDINAVIAN JOURNAL OF RHEUMATOLOGY, 1995, 24 (06) :346-351
[10]  
Nived O, 2002, J RHEUMATOL, V29, P1398