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Peripheral Nervous System Disease in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study.
Hanly, John G; Li, Qiuju; Su, Li; Urowitz, Murray B; Gordon, Caroline; Bae, Sang-Cheol; Romero-Diaz, Juanita; Sanchez-Guerrero, Jorge; Bernatsky, Sasha; Clarke, Ann E; Wallace, Daniel J; Isenberg, David A; Rahman, Anisur; Merrill, Joan T; Fortin, Paul R; Gladman, Dafna D; Bruce, Ian N; Petri, Michelle; Ginzler, Ellen M; Dooley, M A; Steinsson, Kristjan; Ramsey-Goldman, Rosalind; Zoma, Asad A; Manzi, Susan; Nived, Ola; Jonsen, Andreas; Khamashta, Munther A; Alarcón, Graciela S; Svenungsson, Elisabet; van Vollenhoven, Ronald F; Aranow, Cynthia; Mackay, Meggan; Ruiz-Irastorza, Guillermo; Ramos-Casals, Manuel; Lim, S Sam; Inanc, Murat; Kalunian, Kenneth C; Jacobsen, Soren; Peschken, Christine A; Kamen, Diane L; Askanase, Anca; Theriault, Chris; Farewell, Vernon.
Afiliação
  • Hanly JG; Queen Elizabeth II Health Sciences Center and Dalhousie University, Halifax, Nova Scotia, Canada.
  • Li Q; University of Cambridge, Cambridge, UK.
  • Su L; University of Cambridge, Cambridge, UK.
  • Urowitz MB; Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada.
  • Gordon C; University of Birmingham College of Medical and Dental Sciences, Birmingham, UK.
  • Bae SC; Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea.
  • Romero-Diaz J; Instituto Nacional de Ciencias Medicas y Nutrición, Mexico City, Mexico.
  • Sanchez-Guerrero J; Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada.
  • Bernatsky S; McGill University, Montreal, Quebec, Canada.
  • Clarke AE; University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
  • Wallace DJ; Cedars-Sinai and University of California, Los Angeles School of Medicine.
  • Isenberg DA; University College London, London, UK.
  • Rahman A; University College London, London, UK.
  • Merrill JT; Oklahoma Medical Research Foundation, Oklahoma City.
  • Fortin PR; CHU de Québec and Université Laval, Québec City, Québec, Canada.
  • Gladman DD; Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada.
  • Bruce IN; Arthritis Research UK Epidemiology Unit, University of Manchester, NIHR Manchester Musculoskeletal Biomedical Research Centre, and Manchester University NHS Foundation Trust, Manchester, UK.
  • Petri M; Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Ginzler EM; SUNY Downstate Medical Center, Brooklyn, New York.
  • Dooley MA; University of North Carolina, Chapel Hill, North Carolina.
  • Steinsson K; Landspitali University Hospital, Reykjavík, Iceland.
  • Ramsey-Goldman R; Northwestern University and Feinberg School of Medicine, Chicago, Illinois.
  • Zoma AA; Hairmyres Hospital, East Kilbride, UK.
  • Manzi S; Allegheny Health Network, Pittsburgh, Pennsylvania.
  • Nived O; Lund University, Lund, Sweden.
  • Jonsen A; Lund University, Lund, Sweden.
  • Khamashta MA; St. Thomas' Hospital and King's College London School of Medicine, London, UK.
  • Alarcón GS; University of Alabama at Birmingham.
  • Svenungsson E; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
  • van Vollenhoven RF; Amsterdam University Medical Centers, Amsterdam, The Netherlands.
  • Aranow C; Feinstein Institute for Medical Research, Manhasset, New York.
  • Mackay M; Feinstein Institute for Medical Research, Manhasset, New York.
  • Ruiz-Irastorza G; Hospital Universitario Cruces and University of the Basque Country, Barakaldo, Spain.
  • Ramos-Casals M; Institut d'Investigacions Biomèdiques August Pi i Sunyer and Hospital Clínic de Barcelona, Barcelona, Spain.
  • Lim SS; Emory University School of Medicine, Atlanta, Georgia.
  • Inanc M; Istanbul University, Istanbul, Turkey.
  • Kalunian KC; University of California San Diego School of Medicine.
  • Jacobsen S; Rigshospitalet and Copenhagen University Hospital, Copenhagen, Denmark.
  • Peschken CA; University of Manitoba, Winnipeg, Manitoba, Canada.
  • Kamen DL; Medical University of South Carolina, Charleston.
  • Askanase A; NYU Langone Orthopedic Hospital, New York, New York.
  • Theriault C; Queen Elizabeth II Health Sciences Center and Dalhousie University, Halifax, Nova Scotia, Canada.
  • Farewell V; University of Cambridge, Cambridge, UK.
Arthritis Rheumatol ; 72(1): 67-77, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31390162
ABSTRACT

OBJECTIVE:

To determine the frequency, clinical characteristics, associations, and outcomes of different types of peripheral nervous system (PNS) disease in a multiethnic/multiracial, prospective inception cohort of systemic lupus erythematosus (SLE) patients.

METHODS:

Patients were evaluated annually for 19 neuropsychiatric (NP) events including 7 types of PNS disease. SLE disease activity, organ damage, autoantibodies, and patient and physician assessment of outcome were measured. Time to event and linear regressions were used as appropriate.

RESULTS:

Of 1,827 SLE patients, 88.8% were female, and 48.8% were white. The mean ± SD age was 35.1 ± 13.3 years, disease duration at enrollment was 5.6 ± 4.2 months, and follow-up was 7.6 ± 4.6 years. There were 161 PNS events in 139 (7.6%) of 1,827 patients. The predominant events were peripheral neuropathy (66 of 161 [41.0%]), mononeuropathy (44 of 161 [27.3%]), and cranial neuropathy (39 of 161 [24.2%]), and the majority were attributed to SLE. Multivariate Cox regressions suggested longer time to resolution in patients with a history of neuropathy, older age at SLE diagnosis, higher SLE Disease Activity Index 2000 scores, and for peripheral neuropathy versus other neuropathies. Neuropathy was associated with significantly lower Short Form 36 (SF-36) physical and mental component summary scores versus no NP events. According to physician assessment, the majority of neuropathies resolved or improved over time, which was associated with improvements in SF-36 summary scores for peripheral neuropathy and mononeuropathy.

CONCLUSION:

PNS disease is an important component of total NPSLE and has a significant negative impact on health-related quality of life. The outcome is favorable for most patients, but our findings indicate that several factors are associated with longer time to resolution.
Assuntos
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Doenças do Sistema Nervoso Periférico / Doenças dos Nervos Cranianos / Vasculite Associada ao Lúpus do Sistema Nervoso Central / Lúpus Eritematoso Sistêmico Limite: Adulto / Feminino / Humanos / Masculino / Meia-Idade / Jovem adulto Idioma: Inglês Revista: Arthritis Rheumatol Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Canadá

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Doenças do Sistema Nervoso Periférico / Doenças dos Nervos Cranianos / Vasculite Associada ao Lúpus do Sistema Nervoso Central / Lúpus Eritematoso Sistêmico Limite: Adulto / Feminino / Humanos / Masculino / Meia-Idade / Jovem adulto Idioma: Inglês Revista: Arthritis Rheumatol Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Canadá