Autoantibodies and neuropsychiatric events at the time of systemic lupus erythematosus diagnosis: results from an international inception cohort study

2.50
Hdl Handle:
http://hdl.handle.net/2336/29657
Title:
Autoantibodies and neuropsychiatric events at the time of systemic lupus erythematosus diagnosis: results from an international inception cohort study
Authors:
Hanly, J G; Urowitz, M B; Siannis, F; Farewell, V; Gordon, C; Bae, S C; Isenberg, D; Dooley, M A; Clarke, A; Bernatsky, S; Gladman, D; Fortin, P R; Manzi, S; Steinsson, K; Bruce, I N; Ginzler, E; Aranow, C; Wallace, D J; Ramsey-Goldman, R; van Vollenhoven, R; Sturfelt, G; Nived, O; Sanchez-Guerrero, J; Alarcón, G S; Petri, M; Khamashta, M; Zoma, A; Font, J; Kalunian, K; Douglas, J; Qi, Q; Thompson, K; Merrill, J T
Citation:
Arthritis Rheum. 2008, 58(3):843-53
Issue Date:
1-Mar-2008
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-beta2-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.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
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http://dx.doi.org/10.1002/art.23218

Full metadata record

DC FieldValue Language
dc.contributor.authorHanly, J G-
dc.contributor.authorUrowitz, M B-
dc.contributor.authorSiannis, F-
dc.contributor.authorFarewell, V-
dc.contributor.authorGordon, C-
dc.contributor.authorBae, S C-
dc.contributor.authorIsenberg, D-
dc.contributor.authorDooley, M A-
dc.contributor.authorClarke, A-
dc.contributor.authorBernatsky, S-
dc.contributor.authorGladman, D-
dc.contributor.authorFortin, P R-
dc.contributor.authorManzi, S-
dc.contributor.authorSteinsson, K-
dc.contributor.authorBruce, I N-
dc.contributor.authorGinzler, E-
dc.contributor.authorAranow, C-
dc.contributor.authorWallace, D J-
dc.contributor.authorRamsey-Goldman, R-
dc.contributor.authorvan Vollenhoven, R-
dc.contributor.authorSturfelt, G-
dc.contributor.authorNived, O-
dc.contributor.authorSanchez-Guerrero, J-
dc.contributor.authorAlarcón, G S-
dc.contributor.authorPetri, M-
dc.contributor.authorKhamashta, M-
dc.contributor.authorZoma, A-
dc.contributor.authorFont, J-
dc.contributor.authorKalunian, K-
dc.contributor.authorDouglas, J-
dc.contributor.authorQi, Q-
dc.contributor.authorThompson, K-
dc.contributor.authorMerrill, J T-
dc.date.accessioned2008-06-06T15:56:29Z-
dc.date.available2008-06-06T15:56:29Z-
dc.date.issued2008-03-01-
dc.date.submitted2008-06-06-
dc.identifier.citationArthritis Rheum. 2008, 58(3):843-53en
dc.identifier.issn0004-3591-
dc.identifier.pmid18311802-
dc.identifier.doi10.1002/art.23218-
dc.identifier.urihttp://hdl.handle.net/2336/29657-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractOBJECTIVE: 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-beta2-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.en
dc.language.isoenen
dc.publisherWiley-Liss, Inc.en
dc.relation.urlhttp://dx.doi.org/10.1002/art.23218en
dc.subject.meshAdulten
dc.subject.meshAntibodies, Anticardiolipinen
dc.subject.meshAutoantibodiesen
dc.subject.meshCohort Studiesen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshInternational Cooperationen
dc.subject.meshLupus Coagulation Inhibitoren
dc.subject.meshLupus Vasculitis, Central Nervous Systemen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshReceptors, Glutamateen
dc.subject.meshRibosomal Proteinsen
dc.subject.meshbeta 2-Glycoprotein Ien
dc.titleAutoantibodies and neuropsychiatric events at the time of systemic lupus erythematosus diagnosis: results from an international inception cohort studyen
dc.typeArticleen
dc.identifier.journalArthritis and rheumatismen

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