Outcome of neuropsychiatric systemic lupus erythematosus within a defined Swedish population: increased morbidity but low mortality.
OBJECTIVE
To investigate the outcome of neuropsychiatric involvement in systemic lupus erythematosus patients (NPSLE) recruited from a defined population.


METHODS
All cases of adult SLE diagnosed during 1981-1995 within the Lund-Orup Health Care District were followed prospectively and neuropsychiatric manifestations were recorded. The SLICC/ACR (Systemic Lupus International Collaborating Clinics/American College of Rheumatology) Damage Index, mortality and working incapacity were recorded as measures of outcome.


RESULTS
NPSLE manifestations developed in 38% (44/117) of the patients. A high rate of organ damage (SLICC/ACR Damage Index) was recorded in the NPSLE patients (P<0.001). Compared with patients without neuropsychiatric involvement, NPSLE patients were treated more intensively, with glucocorticoids (P<0.01) and cytostatic drugs (P<0.01). When compared with the normal population in the same area, the NPSLE patients had a higher rate of working incapacity (relative risk 4.0, 95% confidence interval 2.06-6.96), whereas mortality was not increased (standardized mortality rate 1.4, 95% confidence interval 0.5-3.0).


CONCLUSIONS
SLE patients with neuropsychiatric involvement have an increased rate of organ damage and a high degree of working incapacity, which illustrates the severity of disease in this subgroup.
Jönsen
A
A
Department of Rheumatology and. Department of Neurology, University Hospital of Lund, Lund, Sweden.
Bengtsson
A A
AA
Nived
O
O
Ryberg
B
B
Sturfelt
G
G
D000203:Activities of Daily Living; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D016001:Confidence Intervals; D004185:Disability Evaluation; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D020945:Lupus Vasculitis, Central Nervous System / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011336:Probability; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones