Factors associated with neuropsychiatric involvement in Latin American patients with systemic lupus erythematosus

Abstract

INTRODUCTION: Factors related to presentation of neuropsychiatric (NP) SLE manifestations, early in the course of the disease, and during follow up have not been clearly established. PURPOSE: To identify disease and non-disease related factors associated with NP manifestations in early SLE. METHODS: We included 1193 patients from the GLADEL inception cohort free of NP involvement at cohort entry. We evaluated the association of demographic, clinical and laboratory data with NP involvement during follow-up. STATISTICAL METHODS: Independent factors associated with NP involvement were identified using a multivariable Cox regression model. RESULTS: Factors independently associated with NP manifestations were: mestizo ethnicity (HR 1.701, 95% CI 1.282-2.258, p=0.0002), myalgias/myositis (HR 1.832, 95% CI 1.335-2.515, p=0.0002), pneumonitis (HR 2.476, 95% CI 1.085-5.648, p=0.0312), shrinking lung (HR 2.428, 95% CI 1.074-5.493, p=0.0331) and hemolytic anemia (HR 1.629, 95% CI 1.130-2.347, p=0.0089). Longer disease duration at cohort entry (13 to 24months) was associated with a lower risk of developing NP manifestations (HR 0.642, 95% CI 0.441-0.934, p=0.0206). CONCLUSIONS: Patients with myalgias/myositis, pneumonitis, shrinking lung and hemolytic anemia are at higher risk of NP involvement, whereas longer disease duration at cohort entry is associated with a lower risk of developing NP involvement