NEUROPSYCHIATRIC MANIFESTATIONS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: PREVALENCE, CLINICAL AND LABORATORY ASSOCIATIONS

Koliadenko D.I., Iaremenko O.B., Nahirna M.I.

• O.O. Bogomolets National Medical University, Kyiv

Summary. Introduction. The prevalence of neuropsychiatric (NP) manifestations in patients with systemic lupus erythematosus (SLE) ranges from 6% to 91%. Their early detection is often challenging due to time-consuming neurocognitive assessment, lack of laboratory biomarkers, and nonspecific imaging results. Objectives. To study the prevalence, clinical and laboratory associations of NP manifestations in patients with SLE in the central region of Ukraine. Materials and methods. The study included 35 patients with SLE, comprising 32 females (91.4%) and 3 males (8.6%). Patients completed simple self-assessment questionnaire for presence of NP symptoms. According to its result, patients were classified into 2 groups: I — positive result, presence of NP symptoms (n=14), II — negative result, absence of NPSLE (n=21). Demographic, clinical, laboratory data, medication use were analyzed. Statistical analysis was performed in EZR software. Results. Positive NP questionnaire result was present in 40.0% of patients, while 64.3% of them have never been previously diagnosed with nervous system involvement. Patients with NPSLE presented higher rates of arthritis (p=0.029), malar rash (p=0.015) and alopecia (p=0.041) than patients without NP symptoms. Logistic regression analysis revealed that polyarthritis (p=0.01) and higher SLEDAI score (p=0.046) were associated with a positive NP questionnaire result. Complement C4 levels were lower in patients with NPSLE than in patients without NP symptoms (p=0.042). The mean daily dose of oral glucocorticoids was significantly higher in patients with NP manifestations of SLE than in patients without them (p=0.029). Conclusions. Rheumatologists should be more encouraged to perform routine screening to detect NP symptoms in SLE patients, adjust treatment whenever possible and consider a need for neuroimaging studies.