Case series: neuropsychiatric symptoms with pediatric systemic lupus erythematosus.
OBJECTIVE
To describe the psychiatric presentation, serologic findings, and neuroimaging patterns in children and adolescents with central nervous system involvement with systemic lupus erythematosus (CNS-SLE).


METHODS
Pediatric patients with psychiatric symptoms who fulfilled the 1997 revised diagnostic American College of Rheumatology criteria for SLE were studied. Complement levels, and anti-double-stranded DNA, anti-Smith, anti-phospholipid, and anti-neuronal antibodies were evaluated. Computed tomography, magnetic resonance imaging, and single photon emission computed tomography (SPECT) neuroimaging studies were reviewed.


RESULTS
The 10 patients with CNS-SLE presented with psychosis, mood disturbance, or confusion, and 8 patients had concomitant neurologic symptoms. The 8 girls and 2 boys ranged in age from 7.5 to 17 years. Serum anti-neuronal antibodies were positive with onset of symptoms and declined with improvement. Initial SPECT was abnormal in all 10 patients and remained abnormal.


CONCLUSIONS
SPECT and anti-neuronal antibodies help confirm CNS involvement in patients with SLE and neuropsychiatric symptoms.
Turkel
S B
SB
Childrens Hospital Los Angeles, 4650 Sunset Blvd. #82, Los Angeles, CA 90027, USA.
Miller
J H
JH
Reiff
A
A
D000208:Acute Disease; D000293:Adolescent; D000906:Antibodies / Q000032:analysis; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002648:Child; D003221:Confusion / Q000209:etiology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D020945:Lupus Vasculitis, Central Nervous System / Q000000981:diagnostic imaging / Q000523:psychology*; D008279:Magnetic Resonance Imaging; D008297:Male; D019964:Mood Disorders / Q000209:etiology* / Q000523:psychology; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000209:etiology* / Q000523:psychology; D011877:Radionuclide Imaging; D012720:Severity of Illness Index; D013057:Spectrum Analysis; D014057:Tomography, X-Ray Computed
D000906:Antibodies