Central nervous system manifestation in patients with SLE: a 12-year retrospective chart review at a tertiary center

ABSTRACT

Central nervous system manifestation of systemic lupus erythematosus [CNS-SLE] is a common complication, which is clinically associated with patient morbidity and mortality. To determine the CNS-SLE manifestations and to determine the predictors of death among the studied cohort. Retrospective. King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. All patients diagnosed with SLE were identified, using a computerized retrieval system, for the period January 1, 2000 to May 31, 2012. Data pertaining to demographics, risk factors for cerebrovascular accident and CNS manifestations were collected from the patients' medical charts. CNS-SLE and the predictors of death among the studied cohort. The study included 307 patients [91% females] with a mean [M +/- SD] age of 35.6 +/- 13 years and mean disease duration of 9 +/- 5 years. CNS manifestations were found in 70 patients [23%]. The commonest was stroke in 25 patients [35%] and aseptic meningitis, cerebritis, recurrent stroke and cavernous sinus thrombosis occurred only in one patient each [1.4%]. The most significant predictors for CNS involvement were hyperlipidemia [OR = 5.48] followed by positive Antiphospholipid antibodies [OR = 2.74]. By univariate analysis CNS involvement, negative anti-nuclear antibody [ANA] and combined low complements were found to be predictors of death. Clinical studies have shown varying results with respect to the prevalence of CNS involvement in SLE. Antiphospholipid antibodies [APA] is a known risk factor whereas the role played by hyperlipidemia in escalating the risk of CNS involvement in SLE warrants further clinical evaluation