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RISS 인기검색어
- 검색키워드
- 저자 : Dooley M. A. (검색결과 2 건)
- 무료
- 기관 내 무료
- 유료
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Hanly, J. G.,Urowitz, M. B.,Sanchez-Guerrero, J.,Bae, S. C.,Gordon, C.,Wallace, D. J.,Isenberg, D.,Alarcó,n, G. S.,Clarke, A.,Bernatsky, S.,Merrill, J. T.,Petri, M.,Dooley, M. A.,Gladman, D.,For Wiley Subscription Services, Inc., A Wiley Company 2007 Vol.56 No.1
<B>Objective</B><P>To describe the prevalence, characteristics, attribution, and clinical significance of neuropsychiatric (NP) events in an international inception cohort of systemic lupus erythematosus (SLE) patients.</P><B>Methods</B><P>The study was conducted by the Systemic Lupus International Collaborating Clinics (SLICC). Patients were enrolled within 15 months of fulfilling the American College of Rheumatology (ACR) SLE classification criteria. All NP events within a predefined enrollment window were identified using the ACR case definitions of 19 NP syndromes. Decision rules were derived to determine the proportion of NP disease attributable to SLE. Clinical significance was determined using the Short Form 36 (SF-36) Health Survey and the SLICC/ACR Damage Index (SDI).</P><B>Results</B><P>A total of 572 patients (88% female) were recruited, with a mean ± SD age of 35 ± 14 years. The mean ± SD disease duration was 5.2 ± 4.2 months. Within the enrollment window, 158 of 572 patients (28%) had at least 1 NP event. In total, there were 242 NP events that encompassed 15 of 19 NP syndromes. The proportion of NP events attributed to SLE varied from 19% to 38% using alternate attribution models and occurred in 6.1–11.7% of patients. Those with NP events, regardless of attribution, had lower scores on the SF-36 and higher SDI scores compared with patients with no NP events.</P><B>Conclusion</B><P>Twenty-eight percent of SLE patients experienced at least 1 NP event around the time of diagnosis of SLE, of which only a minority were attributed to SLE. Regardless of attribution, the occurrence of NP events was associated with reduced quality of life and increased organ damage.</P>
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Hanly, J. G.,Urowitz, M. B.,Siannis, F.,Farewell, V.,Gordon, C.,Bae, S. C.,Isenberg, D.,Dooley, M. A.,Clarke, A.,Bernatsky, S.,Gladman, D.,Fortin, P. R.,Manzi, S.,Steinsson, K.,Bruce, I. N.,Ginzler, E Wiley Subscription Services, Inc., A Wiley Company 2008 Vol.58 No.3
<B>Objective</B><P>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–β2-glycoprotein I, and anti–NR2 glutamate receptor antibodies.</P><B>Methods</B><P>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.</P><B>Results</B><P>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.</P><B>Conclusion</B><P>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.</P>
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