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Autoantibodies and neuropsychiatric events at the time of systemic lupus erythematosus diagnosis

Hanly, J G; Urowitz, M B; Siannis, F; Farewell, V; Gordon, C; Bae, S C; Isenberg, D; Dooley, M A; Clarke, A and Bernatsky, S, et al. (2008) In Arthritis and Rheumatism 58(3). p.843-853
Abstract
Objective. To examine, in an inception cohort of systemic lupus erythematosus (SLE) patients, the association between neuropsychiatric (NP) events and anti-ribosomal P (anti-P), antiphospholipid (lupus anticoagulant [LAC], anticardiolipin), anti-beta 2-glycoprotein I, and anti-NR2 glutamate receptor antibodies. Methods. NP events were identified using the American College of Rheumatology case definitions and clustered into central/peripheral and diffuse/focal events. Attribution of NP events to SLE was determined using decision rules of differing stringency. Autoantibodies were measured without knowledge of NP events or their attribution. Results. Four hundred twelve patients were studied (87.4% female; mean +/- SD age 34.9 +/- 13.5 years,... (More)
Objective. To examine, in an inception cohort of systemic lupus erythematosus (SLE) patients, the association between neuropsychiatric (NP) events and anti-ribosomal P (anti-P), antiphospholipid (lupus anticoagulant [LAC], anticardiolipin), anti-beta 2-glycoprotein I, and anti-NR2 glutamate receptor antibodies. Methods. NP events were identified using the American College of Rheumatology case definitions and clustered into central/peripheral and diffuse/focal events. Attribution of NP events to SLE was determined using decision rules of differing stringency. Autoantibodies were measured without knowledge of NP events or their attribution. Results. Four hundred twelve patients were studied (87.4% female; mean +/- SD age 34.9 +/- 13.5 years, mean +/- SD disease duration 5.0 +/- 4.2 months). There were 214 NP events in 133 patients (32.3%). The proportion of NP events attributed to SLE varied from 15% to 36%. There was no association between autoantibodies and NP events overall. However, the frequency of anti-P antibodies in patients with central NP events attributed to SLE was 4 of 20 (20%), versus 3 of 107 (2.8%) in patients with other NP events and 24 of 279 (8.6%) in those with no NP events (P = 0.04). Among patients with diffuse NP events, 3 of 11 had anti-P antibodies (27%), compared with 4 of 111 patients with other NP events (3.6%) and 24 of 279 of those with no NP events (8.6%) (P 0.02). Specific clinical-serologic associations were found between anti-P and psychosis attributed to SLE (P = 0.02) and between LAC and cerebrovascular disease attributed to SLE (P = 0.038). There was no significant association between other autoantibodies and NP events. Conclusion. Clinically distinct NP events attributed to SLE and occurring around the time of diagnosis were found to be associated with anti-P antibodies and LAC. This Suggests that there are different autoimmune pathogenetic mechanisms, although low sensitivity limits the clinical application of testing for these antibodies. (Less)
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published
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Arthritis and Rheumatism
volume
58
issue
3
pages
843 - 853
publisher
John Wiley & Sons
external identifiers
  • wos:000253895500025
  • scopus:40549134936
ISSN
1529-0131
DOI
10.1002/art.23218
language
English
LU publication?
yes
id
c001c694-f25b-43c1-ba60-87418f004e11 (old id 1191593)
date added to LUP
2008-09-08 17:13:37
date last changed
2017-09-17 05:08:11
@article{c001c694-f25b-43c1-ba60-87418f004e11,
  abstract     = {Objective. To examine, in an inception cohort of systemic lupus erythematosus (SLE) patients, the association between neuropsychiatric (NP) events and anti-ribosomal P (anti-P), antiphospholipid (lupus anticoagulant [LAC], anticardiolipin), anti-beta 2-glycoprotein I, and anti-NR2 glutamate receptor antibodies. Methods. NP events were identified using the American College of Rheumatology case definitions and clustered into central/peripheral and diffuse/focal events. Attribution of NP events to SLE was determined using decision rules of differing stringency. Autoantibodies were measured without knowledge of NP events or their attribution. Results. Four hundred twelve patients were studied (87.4% female; mean +/- SD age 34.9 +/- 13.5 years, mean +/- SD disease duration 5.0 +/- 4.2 months). There were 214 NP events in 133 patients (32.3%). The proportion of NP events attributed to SLE varied from 15% to 36%. There was no association between autoantibodies and NP events overall. However, the frequency of anti-P antibodies in patients with central NP events attributed to SLE was 4 of 20 (20%), versus 3 of 107 (2.8%) in patients with other NP events and 24 of 279 (8.6%) in those with no NP events (P = 0.04). Among patients with diffuse NP events, 3 of 11 had anti-P antibodies (27%), compared with 4 of 111 patients with other NP events (3.6%) and 24 of 279 of those with no NP events (8.6%) (P 0.02). Specific clinical-serologic associations were found between anti-P and psychosis attributed to SLE (P = 0.02) and between LAC and cerebrovascular disease attributed to SLE (P = 0.038). There was no significant association between other autoantibodies and NP events. Conclusion. Clinically distinct NP events attributed to SLE and occurring around the time of diagnosis were found to be associated with anti-P antibodies and LAC. This Suggests that there are different autoimmune pathogenetic mechanisms, although low sensitivity limits the clinical application of testing for these antibodies.},
  author       = {Hanly, J G and Urowitz, M B and Siannis, F and Farewell, V and Gordon, C and Bae, S C and Isenberg, D and Dooley, M A and Clarke, A and Bernatsky, S and Gladman, D and Fortin, P R and Manzi, S and Steinsson, K and Bruce, I N and Ginzler, E and Aranow, C and Wallace, D J and Ramsey-Goldman, R and van Vollenhoven, R and Sturfelt, Gunnar and Nived, Ola and Sanchez-Guerrero, J and Alarcon, G S and Petri, M and Khamashta, M and Zoma, A and Font, J and Kalunian, K and Douglas, J and Qi, Q and Thompson, K and Merrill, J T},
  issn         = {1529-0131},
  language     = {eng},
  number       = {3},
  pages        = {843--853},
  publisher    = {John Wiley & Sons},
  series       = {Arthritis and Rheumatism},
  title        = {Autoantibodies and neuropsychiatric events at the time of systemic lupus erythematosus diagnosis},
  url          = {http://dx.doi.org/10.1002/art.23218},
  volume       = {58},
  year         = {2008},
}