Evaluation of magnetic resonance imaging abnormalities in juvenile onset neuropsychiatric systemic lupus erythematosus

The aim of this study was to describe the abnormalities identified with conventional MRI in children with neuropsychiatric systemic lupus erythematosus (NPSLE). This was single-centre (Great Ormond Street Hospital, London) retrospective case series of patients with juvenile NPSLE seen in 2003–2013....

Full description

Saved in:

Bibliographic Details
Published in:	Clinical rheumatology 2016-10, Vol.35 (10), p.2449-2456
Main Authors:	Al-Obaidi, M, Saunders, D., Brown, S., Ramsden, L., Martin, N., Moraitis, E., Pilkington, C. A., Brogan, P. A., Eleftheriou, D.
Format:	Article
Language:	eng
Subjects:	Adolescent Atrophy - diagnostic imaging Atrophy - pathology Brain - diagnostic imaging Brain - pathology Child Child, Preschool Female Headache - complications Headache - diagnostic imaging Headache - pathology Humans Lupus Vasculitis, Central Nervous System - complications Lupus Vasculitis, Central Nervous System - diagnostic imaging Lupus Vasculitis, Central Nervous System - pathology Magnetic Resonance Imaging Male Medicine Medicine & Public Health Mood Disorders - complications Mood Disorders - diagnostic imaging Mood Disorders - pathology Original Original Article Retrospective Studies Rheumatology
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	The aim of this study was to describe the abnormalities identified with conventional MRI in children with neuropsychiatric systemic lupus erythematosus (NPSLE). This was single-centre (Great Ormond Street Hospital, London) retrospective case series of patients with juvenile NPSLE seen in 2003–2013. Brain MR images of the first episode of active NPSLE were reviewed. All patients fulfilled the 1999 ACR case definitions for NPSLE syndromes. Presenting neuropsychiatric manifestations, immunological findings and treatment are reported. Results are expressed as median and ranges or percentages. Fisher’s exact test was used to identify clinical predictors of abnormal MRI. A total of 27 patients (22 females), median age 11 years (4–15), were identified. Presenting clinical symptoms included the following: headaches (85.1 %), mood disorder/depression (62.9 %), seizures (22.2 %), acute psychosis (18.5 %), cognitive dysfunction (14.8 %), movement disorder (14.8 %), acute confusional state (14.8 %), aseptic meningitis (7.4 %), demyelinating syndrome (3.7 %), myelopathy (3.7 %), dysautonomia (3.7 %) and cranial neuropathy (3.7 %). The principal MR findings were as follows: (1) absence of MRI abnormalities despite signs and symptoms of active NPSLE (59 %); (2) basilar artery territory infarction (3 %); (3) focal white matter hyperintensities on T2-weighted imaging (33 %); (4) cortical grey matter lesions (3 %); and (5) brain atrophy (18.5 %). The presence of an anxiety disorder strongly associated with abnormal MRI findings ( p = 0.008). In over half the children with NPSLE, no conventional MRI abnormalities were observed; white matter hyperintensities were the most commonly described abnormalities. Improved MR techniques coupled with other alternative diagnostic imaging modalities may improve the detection rate of brain involvement in juvenile NPSLE.
ISSN:	0770-3198 1434-9949