Determination of the Risk Factors Contributing to the Development of Neuropsychiatric Lupus in a Systemic Lupus Erythematosus Cohort

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dc.contributor.authorBankole, Adegbenga A.en
dc.contributor.authorKazmi, Taskeen R.en
dc.contributor.authorStrazanac, Alyssa R.en
dc.date.accessioned2022-02-18T18:31:05Zen
dc.date.available2022-02-18T18:31:05Zen
dc.date.issued2021-12-03en
dc.date.updated2022-02-18T18:31:03Zen
dc.description.abstractBackground: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a complex, varied clinical presentation that is both more common and has poor outcomes in women of color. SLE outcomes also seem to be influenced by socioeconomic factors. Neuropsychiatric lupus (NPL) is a common manifestation of SLE that is difficult to diagnose and treat and has poor clinical outcomes. There is no clear relationship between NPL and SLE-related autoantibodies, and this contributes to the difficulty in diagnosing NPL. As a result, NPL is a significant contributor to morbidity and mortality in patients with SLE. Objective: The purpose of this study was to examine the relationship between serological and socioeconomic factors in the development of NPL in our patient cohort and determine the risk factors for the development of NPL. Methods: This was an SLE single-center, retrospective chart review study that was performed at a university-based tertiary referral center. Patients aged 18 and older who meet the American College of Rheumatology (ACR) 1997 criteria and were seen between June 1st, 2015, and June 1st, 2019, were included in this study. Overall, 629 patients with SLE were identified, and 263 patients were included. Demographic and serological data were collected. Supplemental socioeconomic information for each zip code in Southwest Virginia was obtained from the United States Government Census website. Continuous variables were analyzed using the T-test or Mann-Whitney U test. Categorical variables were analyzed using chi-square tests or Fisher's exact tests. Statistical analysis was performed using SAS9.4, and p-value < 0.05 was considered statistically significant. Results: We reviewed a number of risk factors including age, sex, race, and median household income (MHI), noting no statistical relationship between these factors and the diagnosis of NPL. We did find that the presence of antiphospholipid antibodies (aPL) was significantly associated with a diagnosis of NPL and that complement 4 (C4) levels trended toward statistical significance. Conclusion: In our cohort of patients, there was no relationship between age, sex, race, and median household income, and the diagnosis of NPL. There was a statistically significant relationship between aPL and the diagnosis of NPL. Other SLE-related antibodies showed no statistical relationship with the diagnosis of NPL. Although not statistically significant, there was a trend toward significance between complement 4 (C4) levels and the diagnosis of NPL.en
dc.description.versionPublished versionen
dc.format.extentPages e20129en
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.7759/cureus.20129en
dc.identifier.eissn2168-8184en
dc.identifier.issn2168-8184en
dc.identifier.issue12en
dc.identifier.orcidBankole, Adegbenga [0000-0001-6464-5367]en
dc.identifier.otherPMC8723701en
dc.identifier.pmid35003967en
dc.identifier.urihttp://hdl.handle.net/10919/108751en
dc.identifier.volume13en
dc.language.isoenen
dc.publisherCureusen
dc.relation.urihttps://www.ncbi.nlm.nih.gov/pubmed/35003967en
dc.rightsCreative Commons Attribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectantiphospholipid antibodyen
dc.subjectcomplementsen
dc.subjectneurologyen
dc.subjectneurology and psychiatric disordersen
dc.subjectneuropsychiatric lupusen
dc.subjectpsychiatryen
dc.subjectsystemic lupus erythematosusen
dc.subjectsystemic lupus erythematosus with polyneuropathyen
dc.subject11 Medical and Health Sciencesen
dc.titleDetermination of the Risk Factors Contributing to the Development of Neuropsychiatric Lupus in a Systemic Lupus Erythematosus Cohorten
dc.title.serialCureusen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.otherArticleen
dcterms.dateAccepted2021-12-02en
pubs.organisational-group/Virginia Techen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicineen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicine/Internal Medicineen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicine/Internal Medicine/Rheumatologyen

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