J Med Assoc Thai 2017; 100 (11):1196

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Neuropsychiatric Manifestations in Pediatric Systemic Lupus Erythematosus
Suwanpakdee P Mail, Nabangchang C , Lumpaopong A

Background: The frequency of neuropsychiatric manifestations in systemic lupus erythematosus (NPSLE) is rare.

Objective: To determine the prevalence and clinical features of pediatric NPSLE.

Material and Method: We reviewed the medical records of pediatric SLE patients between January 1988 and August 2009. Sixty-six SLE patients were identified. The patients who had lupus-like symptoms and had NPSLE secondary to other causes were excluded.

Results: NPSLE was identified in 17 patients (25.8%). The median age onset was 13 years. Eight patients (12.1%) had NPSLE on initial diagnosis of SLE. Ten patients (58.8%) developed NP symptoms within the first year of SLE, while seven patients (41.2%) developed these symptoms after one year of SLE diagnosis. The most common symptoms were seizure (52.9%), stroke (29.4%), and movement disorder (17.6%). No laboratory finding was correlated with NPSLE. Brain imaging showed abnormalities in more than 50% of patients including infarction, vasculitis, brain atrophy, and subdural effusion.

Conclusion: The present study demonstrated that most of NPSLE patients developed symptoms within the first year after diagnosis. Interestingly, the prevalence of seizures in Asian pediatric SLE was found to be more significant than non-Asian population. We hypothesized that ethnicity may be one of the potential predictors of NP manifestations.

Keywords: NPSLE, Neuropsychiatric, Pediatric systemic lupus erythematosus

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