Immuno-serological profile of Systemic Erythemic Lupus (SLE) patients with neuropsychiatric manifestations (NP)

Introduction

goal of the study was to establish the correlation between immuno-serological anomalies and the existence of NP in patients with SLE

Methods

the study included 60 SLE patients (54 female, 6 male), all with signs of NP. The age of patients varied between 17 and 71 years (42.3 + 13.0). The study consisted of clinical evaluation by rheumatologist, neurologist, psychiatrist, neuro-ophtalmologist, as well as electrophysiological (EEG, EP, EMNG) methods. It also included visualization (NMR) methods for determining pathologies in the CNS. Different auto-antibodies and other immuno-serological markers displayed positive results with the following frequency: ANA (91.7%); anti-dsDNA (40.0%); anti-DNP (48.3%); CIK (45.0%); low C3/C4 levels (18.3%). Antiphospholipid antibodies (aPL) were positive: LA in 14.8% pts; aCL (IgG and IgM) in 23.1% pts. 30 patients were tested for anti-SM, anti-U1RNP, cANCA and pANCA and were positive in: anti-SM- 20.0%, anti-U1RNP- 50.0%, cANCA- 10.0%, pANCA- 30.0%.

Results

there was no statistically significant correlation between ANA, anti-dsDNA, CIK, anti-DNP, C3/C4 and the diagnosis of certain neuro-psychiatric manifestations in our SLE patient group. Patients with focal cerebral dysfunctions were shown to have a higher frequency of aPL: LA (P = 0.0111) and aCL (P = 0.0148). A correlation was found between cANCA (P = 0.0406), pANCA (P = 0.0348), anti-U1RNP (P = 0.0309) and skin vasculitis, as well as between pANCA and CVI diagnosis in neuro-lupus patients (P = 0.0028).

Conclusion

our study did not show the correlation between auto-antibodies in SLE patients with NP and certain types of CNS/PNS lesions, except for the connection between aPL and focal cerebral dysfunctions, as well as pANCA's correlation with cerebro-vascular stroke diagnosis.