Comprehensive analysis of disease activity, neuropsychiatric symptoms, imaging features and risk factors for seizure in hospitalized patients with juvenile-onset neuropsychiatric systemic lupus erythematosus.

Abstract

Background: Neuropsychiatric systemic lupus erythematosus (NPSLE) is a common complication of juvenile systemic lupus erythematosus, with high morbidity and lethality rates. This study aimed to comprehensively analyze the clinical characteristics and related influencing factors of NPSLE, providing important basis for the early detection and early diagnosis of NPSLE.

Methods: The clinical data of juvenile-onset NPSLE patients, juvenile non-NPSLE patients, and adult-onset NPSLE patients admitted to the Xiangya Second Hospital of Central South University from January 2010 to December 2023 were retrospectively analyzed. The data of the juvenile-onset NPSLE patients were divided into subgroups via a cluster analysis. Drawing upon retrospective clinical data and case reports from databases, a thorough synthesis of the characteristics of Juvenile-onset NPSLE cases presenting with seizures was presented. Multivariate logistic regression analysis was utilized to assess influencing factors of juvenile-onset NPSLE with seizures.

Results: A total of 89 juvenile-onset NPSLE patients, 219 juvenile-onset non-NPSLE patients, and 150 adult-onset NPSLE patients were included. Compared to non-NPSLE patients, juvenile-onset NPSLE patients showed higher rates of myositis, cardiac involvement, overlap syndrome, anti-SSA antibodies and ANCA positivity, as well as higher disease activity scores. Individuals with juvenile-onset NPSLE exhibited a greater likelihood of headaches, seizures, and movement disorders and renal involvement, positive rates of anti-dsDNA and anti-nucleosome antibodies, and disease activity scores, while displaying a lower probability of polyneuropathy in comparison to adult patients. Disease activity emerged as an independent risk factor for seizures.

Conclusion: These findings contribute to the early detection of potential NPSLE patients and help clinicians to pay attention to potentially high-risk populations for NPSLE.