Abstract
Systemic Lupus Erythematosus (SLE) and concomitant complication of Neuropsychiatric lupus (NPSLE) are rarely reported among Africans. This retrospective study has the objectives of highlighting the clinical and laboratory characteristics of SLE subjects with neuropsychiatric manifestations seen in a private practice rheumatology clinic and comparing these with studies elsewhere. Such subjects were diagnosed using the American College of Rheumatology (ACR) criteria for SLE as well as the ACR Case definition for Neuropsychiatric SLE (NPSLE). A total of thirty three subjects (51.6%) out of the sixty four diagnosed SLE had features of NPSLE. Females were more commonly affected and the mean age was 32.8 years. Most of the subjects had either one or two concomitant syndromes. Headache was the commonest presentation (66.6%) while other common presentations were seizures (42.4),psychosis (30.3%) were also seen. Dementia was the least seen. The mean erythrocyte sedimentation rate was 95.5mm/hr. Serology tests showed high frequencies of Anti Nuclear Antibody (ANA) and Anti ds DNA. Treatment was with standard immunosuppressives, and epileptics where indicated. The outcome was generally good with 54.5% better after six months while 7 subjects (21%) were lost to follow up and three were known to have died. NPSLE is a common presentation among Nigerian SLE patients and the pattern is as seen in other reports, though the frequencies of the syndromes vary widely. Early recognition and management with immunosuppressives are required.
Keywords: Lupus neuropsychiatric syndromes Nigerians
Résumé
Cette étude rétrospective a pour objectif d’illuminer les caractéristiques cliniques et laboratoires des sujets ayant SLE avec les manifestations neuropsychiatri-ques observé dans la clinique privée de rhumatologie et comparé avec d’autres études effectuées ailleurs. De tels sujets étaient diagnostiqués utilisant Les critéres du Collége Americain de Rhumatologie (CAR) pour le SLE aussi bien que des cas défini de neuropsychiatrie SLE (NPSLE). Au total 33 sujets (51.6%) sur soixante quatre cas diagnostiqués avaient les caractéristiques du NPSLE. Les fêmeles étaient plus affectées et la moyenne d’age était de 32.8 ans. La plupart des sujets avaient soit une ou deux syndromes concomitant. Les maux de tête était le symptome clinique le plus commun (66.6%) alorsque d’autres présentations cliniques ,les convulsions (42.4) et les psychoses (30.3%) étaient observées. Dementie était le moindre symptome observée. Le taux moyen de sédimentation était de 95.5mm/hr. Les tests sérologiques montraient les fréquences élevées d’anticorps anti nucléaires (AAN) et Anti ADN. Le traitement était á l’aide des immunosuppressants standard, et les épileptiques ou indiqués. Generalement, le résultat était satisfaisant avec 54.5% mieux après 6 mois, bien que 7 sujets (21%) perdaient de suivi et trois décés. Le NPSLE est une présentation commune parmi les SLE patients Nigérian et la fréquence semblable á d’autres rapports, bienque les fréquences des syndromes variant grandement. La détection précose et les soins á l’aide des immunosuppressants sont nécessaire.
Correspondence: Prof. O.O. Adelowo, P.O. Box 7231, Ikeja, Lagos. Nigeria. Email: femiadelowo2003@yahoo.com
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