title: [Recent progress in neuropsychiatric systemic lupus erythematosus].
abstract: Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disease. Neuropsychiatric manifestations of SLE (NPSLE) are associated with increased morbidity and mortality. According to the American College of Rheumatology (ACR) classification, NPSLE consists of two broad categories: central and peripheral nervous system syndromes, which cover a wide range of clinical presentations such as stroke, seizures, and psychosis. The aim of targeted treatment for SLE is to reduce damage accrual; damage can be reduced by controlling the disease activity, minimizing the use of corticosteroids, and optimizing the management of comorbidities like cardiovascular risk factors. In patients with life- or organ-threatening manifestations of SLE, the combined use of high-dose corticosteroid and immunosuppressants, such as cyclophosphamide pulse and mycophenolate mofetil, is necessary. If patients do not respond to conventional treatment, biological agents, including anti-BAFF, anti-CD20, anti-CD22, and CTLA4-Ig, are additional available therapies. A more effective and less toxic approach to SLE treatment remains to be found.
authors.affiliation: The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health.
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Tanaka
mesh_terms: D000906:Antibodies / Q000627:therapeutic use; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D020945:Lupus Vasculitis, Central Nervous System / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D000906:Antibodies