TY - JOUR
T1 - Central nervous system involvement as the presenting manifestation of autoimmune rheumatic diseases
T2 - An observational study using the American College of Rheumatology nomenclature for neuropsychiatric lupus
AU - Mastorodemos, Vasileios
AU - Mamoulaki, Marilena
AU - Kritikos, Herakles
AU - Plaitakis, Andreas
AU - Boumpas, Dimitrios T.
PY - 2006/11
Y1 - 2006/11
N2 - Objective: We sought to describe CNS involvement as initial presentation of autoimmune rheumatic diseases using a standardized nomenclature. Patients and methods: A 6-year observational study (1999-2005) was conducted in the University Hospital of Heraklion Crete, a regional referral secondary/tertiary care academic center. Patients presenting with new neurological symptoms of acute/sub-acute onset underwent clinical and laboratory screening for systemic autoimmune disorders. The diagnosis of an autoimmune rheumatic disorder was based upon the American College of Rheumatology (ACR) classification criteria, whereas for primary antiphospholipid syndrome (PAPS) we used the Sapporo preliminary criteria. In order to describe the neurological syndromes we used the ACR nomenclature for neuropsychiatric lupus. Results: During this period fourteen patients (ten females and four males) were recorded. Eight patients had systemic lupus erythematosus (SLE), four had primary APS and the remaining two had systemic vasculitis. Four out of the eight SLE patients had secondary APS. Two of them presented with movement disorder (chorea). The other two and all four patients with primary APS presented with cerebrovascular disease (CVD). These six patients comprised the 5.7% of young adults under < 45 years old with cerebrovascular accident admitted over the 6-year period. Conclusions: SLE and APS either primary or secondary to SLE were the most common underlying systemic autoimmune rheumatic diseases, in patients presenting with a neurological event of acute onset. Young adults (< 45 years old) with CVD should undertake screening for SLE/APS.
AB - Objective: We sought to describe CNS involvement as initial presentation of autoimmune rheumatic diseases using a standardized nomenclature. Patients and methods: A 6-year observational study (1999-2005) was conducted in the University Hospital of Heraklion Crete, a regional referral secondary/tertiary care academic center. Patients presenting with new neurological symptoms of acute/sub-acute onset underwent clinical and laboratory screening for systemic autoimmune disorders. The diagnosis of an autoimmune rheumatic disorder was based upon the American College of Rheumatology (ACR) classification criteria, whereas for primary antiphospholipid syndrome (PAPS) we used the Sapporo preliminary criteria. In order to describe the neurological syndromes we used the ACR nomenclature for neuropsychiatric lupus. Results: During this period fourteen patients (ten females and four males) were recorded. Eight patients had systemic lupus erythematosus (SLE), four had primary APS and the remaining two had systemic vasculitis. Four out of the eight SLE patients had secondary APS. Two of them presented with movement disorder (chorea). The other two and all four patients with primary APS presented with cerebrovascular disease (CVD). These six patients comprised the 5.7% of young adults under < 45 years old with cerebrovascular accident admitted over the 6-year period. Conclusions: SLE and APS either primary or secondary to SLE were the most common underlying systemic autoimmune rheumatic diseases, in patients presenting with a neurological event of acute onset. Young adults (< 45 years old) with CVD should undertake screening for SLE/APS.
KW - Antiphospholipid syndrome
KW - Cerebrovascular disease
KW - Initial
KW - Neuropsychiatric disease
UR - http://www.scopus.com/inward/record.url?scp=33846441643&partnerID=8YFLogxK
M3 - Article
C2 - 17207377
AN - SCOPUS:33846441643
SN - 0392-856X
VL - 24
SP - 629
EP - 635
JO - Clinical and Experimental Rheumatology
JF - Clinical and Experimental Rheumatology
IS - 6
ER -