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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Autoantibodies and neuropsychiatric events at the time of systemic lupus erythematosus diagnosis
Arthritis and rheumatism, v 58(3), pp 843-853
2008
PMID: 18311802
Featured in Collection : UN Sustainable Development Goals @ Drexel
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.
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Details
- Title
- Autoantibodies and neuropsychiatric events at the time of systemic lupus erythematosus diagnosis
- Creators
- J. G. Hanly - Dalhousie UniversityM. B. Urowitz - University of TorontoF. Siannis - National and Kapodistrian University of AthensV. Farewell - University of CambridgeC. Gordon - University of BirminghamS. C. Bae - Hanyang University Medical CenterD. Isenberg - UCL AustraliaM. A. Dooley - University of North Carolina at Chapel HillA. Clarke - McGill UniversityS. Bernatsky - McGill UniversityD. Gladman - Toronto Western HospitalP. R. Fortin - University of TorontoS. Manzi - University of PittsburghK. Steinsson - National University Hospital of IcelandI. N. Bruce - University of ManchesterE. Ginzler - SUNY Downstate Health Sciences UniversityC. Aranow - Columbia University Irving Medical CenterD. J. Wallace - University of California, Los AngelesR. Ramsey-Goldman - Northwestern UniversityR. van Vollenhoven - Karolinska InstitutetG. Sturfelt - Lund UniversityO. Nived - Lund UniversityJ. Sanchez-Guerrero - Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránG. S. Alarcon - University of Alabama at BirminghamM. Petri - Johns Hopkins UniversityM. Khamashta - King's College LondonA. Zoma - NHS LanarkshireJ. Font - Queen Elizabeth II Health Sciences CentreK. Kalunian - University of California, San DiegoJ. Douglas - Dalhousie UniversityQ. Qi - Queen Elizabeth II Health Sciences CentreK. Thompson - Queen Elizabeth II Health Sciences CentreJ. T. Merrill - Oklahoma Medical Research FoundationSyst Lupus Int Collab Clin
- Publication Details
- Arthritis and rheumatism, v 58(3), pp 843-853
- Publisher
- Wiley
- Number of pages
- 11
- Grant note
- R01AR043727 / NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS) M01-RR-00048; M01 RR000048; M01-RR-00052; M01 RR000052 / NCRR NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR) Wellcome Trust; European Commission M01RR000048 / NATIONAL CENTER FOR RESEARCH RESOURCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR) 86526-2; 86526-1 / CIHR; Canadian Institutes of Health Research (CIHR) MC_U105261167 / MRC; UK Research & Innovation (UKRI); Medical Research Council UK (MRC) MC_U105261167 / Medical Research Council; UK Research & Innovation (UKRI); Medical Research Council UK (MRC); European Commission K24-AR-02318; P60-AR-48095; AR-43727; P60-AR-48098; P60 AR048098; P60 AR048095; R01 AR043727 / NIAMS NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS) Arthritis Research UK; Versus Arthritis
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000253895500025
- Scopus ID
- 2-s2.0-40549134936
- Other Identifier
- 991021934002204721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Rheumatology