系统性红斑狼疮后可逆性脑病综合征的临床特征和危险因素:一项病例对照研究。

IF 1.9 4区 医学 Q3 RHEUMATOLOGY
Lupus Pub Date : 2025-09-01 Epub Date: 2025-08-03 DOI:10.1177/09612033251366401
Kaustav Bhowmick, Rashmi Roongta, Sumantro Mondal, Dipendra Nath Ghosh, Soumya Dey, Gautam Raj Panjabi, Angan Karmakar, Mavidi Sunil Kumar, Sonali Dey, Sudipta Ghorai, Partha Ghorai, Hiramanik Sit, Subhankar Haldar, Pradyot Sinhamahapatra, Biswadip Ghosh, Geetabali Sircar, Parasar Ghosh
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Fifty-three control participants with neuropsychiatric symptoms as per the 1999 American College of Rheumatology case definition criteria were selected from the departmental SLE cohort.Results26 episodes of PRES were identified in 25 patients. Seizures (88.46%) and headaches (53.85%) were the commonest presenting manifestations with the occipital (96.15%) and parietal lobes (84.62%) being the commonly involved sites. Nephritis (96.15% vs 60.38%, <i>p</i> = 0.001), hypertension at PRES onset (76.92% vs 18.87%, <i>p</i> = 0.000), Direct Coomb's test (DCT) positivity (50.00% vs 20.75%, <i>p</i> = 0.008), high extra-neurological disease activity (SELENA-SLEDAI - <i>N</i>: 20.62±8.77 vs 14.15 ± 5.51, <i>p</i> = 0.002), lupus enteritis (15.38% vs 1.89%, <i>p</i> = 0.038), and neutrophilia (73.08% vs 20.75%, <i>p</i> = 0.000) were identified as risk factors for PRES on univariate analysis. 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引用次数: 0

摘要

目的探讨系统性红斑狼疮(SLE)患者后路可逆性脑病综合征(PRES)的临床特点及危险因素。方法回顾性分析2017年1月1日至2024年1月31日在印度加尔各答IPGME&R临床免疫与风湿病学系因PRES住院的SLE患者。根据1999年美国风湿病学会病例定义标准,从部门SLE队列中选择53名有神经精神症状的对照受试者。结果25例患者出现了26次PRES发作。癫痫(88.46%)和头痛(53.85%)是最常见的表现,枕叶(96.15%)和顶叶(84.62%)是最常见的受累部位。单因素分析发现,肾炎(96.15% vs 60.38%, p = 0.001)、PRES发病时高血压(76.92% vs 18.87%, p = 0.000)、直接库姆试验(Direct Coomb’s test, DCT)阳性(50.00% vs 20.75%, p = 0.008)、神经外疾病活动性高(selina - sledai - N: 20.62±8.77 vs 14.15±5.51,p = 0.002)、狼疮肠炎(15.38% vs 1.89%, p = 0.038)、中性粒细胞增多(73.08% vs 20.75%, p = 0.000)是PRES的危险因素。多因素分析发现高血压[p = 0.014]、DCT阳性(p = 0.013)、中性粒细胞增多(p = 0.025)、狼疮性肠炎(0.038)是独立危险因素。单因素分析发现,U1RNP/Sm和既往血栓事件的存在对PRES具有保护作用。结论在我们的研究中,SLE患者的pres与高神经外疾病活动性相关。高血压、DCT阳性、嗜中性粒细胞和狼疮性肠炎被认为是该病的重要危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical profile and risk factors of posterior reversible encephalopathy syndrome in systemic lupus erythematosus: A case-control study.

ObjectivesTo investigate the clinical profile and risk factors of Posterior Reversible Encephalopathy Syndrome (PRES) in patients with Systemic Lupus Erythematosus (SLE).MethodsIn this retrospective study, the SLE patients admitted with PRES in the Department of Clinical Immunology and Rheumatology, IPGME&R, Kolkata, India from January 1, 2017 to January 31, 2024, were identified. Fifty-three control participants with neuropsychiatric symptoms as per the 1999 American College of Rheumatology case definition criteria were selected from the departmental SLE cohort.Results26 episodes of PRES were identified in 25 patients. Seizures (88.46%) and headaches (53.85%) were the commonest presenting manifestations with the occipital (96.15%) and parietal lobes (84.62%) being the commonly involved sites. Nephritis (96.15% vs 60.38%, p = 0.001), hypertension at PRES onset (76.92% vs 18.87%, p = 0.000), Direct Coomb's test (DCT) positivity (50.00% vs 20.75%, p = 0.008), high extra-neurological disease activity (SELENA-SLEDAI - N: 20.62±8.77 vs 14.15 ± 5.51, p = 0.002), lupus enteritis (15.38% vs 1.89%, p = 0.038), and neutrophilia (73.08% vs 20.75%, p = 0.000) were identified as risk factors for PRES on univariate analysis. Multivariate analysis found hypertension [p = 0.014], DCT positivity (p = 0.013), neutrophilia (p = 0.025), and lupus enteritis (0.038) as independent risk factors. The presence of U1RNP/Sm and prior thrombotic events were found to be protective against PRES on univariate analysis.ConclusionPRES in SLE in our study was associated with high extra-neurological disease activity. Hypertension, DCT positivity, neutrophilia, and lupus enteritis were identified as important risk factors for the condition.

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来源期刊
Lupus
Lupus 医学-风湿病学
CiteScore
4.20
自引率
11.50%
发文量
225
审稿时长
1 months
期刊介绍: The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…
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