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Prior psychosis, neuropathy cited among risk factors for seizure in patients with SLE
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The risk for developing seizures following a diagnosis of systemic lupus erythematosus was higher in patients with a prior history of psychosis, neuropathy, proteinuria, anti-Sm antibodies, low complement levels and current use of corticosteroids, according to recently published research.
Using the Hopkins Lupus Cohort of 2,259 patients with systemic lupus erythematosus (SLE) who were recruited between June 1987 and June 2013, researchers identified 157 patients who developed seizures. Patients with a prior history of seizures were excluded from the study. Overall, 92.5% of patients were women and 82.5% of patients were younger than age 45 years. About half of patients white and 37.6% were African American.
A first seizure occurred around the time of SLE diagnosis in 37 patients. Patients with a history of malar rash, proteinuria, serositis and a history of psychosis were more likely to have a seizure around the time of SLE diagnosis (within 1 year prior to diagnosis or more than 45 days after diagnosis). A trend toward a higher risk for patients with anti-Sm antibodies did not reach significance.
A first seizure occurrence at least 45 days after SLE diagnosis occurred in 120 patients. Later seizure onset was negatively associated with higher income, longer disease duration and recent calendar year. No associations based on age, sex, ethnicity, education level, smoking status or history of alcohol abuse were observed.
Neuropsychiatric manifestations associated with the onset of seizures in patients with SLE included psychosis, organic brain syndrome, aseptic meningitis, cerebrovascular disease, cranial or peripheral neuropathy, cognitive impairment and a history of an abnormal CT scan. Anti-Sm antibodies, low complement 3 (C3) and C4 were associated with new onset of seizures. Patients with anti-Sm antibodies had a borderline higher rate of seizures with a risk ratio of 1.518. – by Shirley Pulawski
Disclosure: The researchers report a grant from the NIH (NIH AR43727) and by grant number UL1 RR 025005 from the National Center for Research Resources.
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