Abstract
Neuropsychiatric manifestations in patients with systemic lupus erythematosus (SLE) are well-recognized symptoms although the pathophysiology of neuropsychiatric SLE (NPSLE) is unclear. Since an association with antiphospholipid antibodies has been reported, we examined the prevalence of antiphosphatidylserine–prothrombin antibodies (anti-PS/PT Abs), lupus anticoagulant (LA), anticardiolipin/β2-glycoprotein I antibodies (anti-β2-GPI Abs), and antiribosomal P protein antibodies (antiribosomal P Abs) in 68 SLE patients and analyzed their associations with neuropsychiatric manifestations. The prevalence of LA was significantly higher in the patients with neuropsychiatric (NP) features than those without NP features (P < 0.02). The levels of anti-PS/PT antibody were also significantly higher in the patients with NP features than those without NP features (P < 0.01). The results indicate that LA positivity and higher levels of anti-PS/PT antibody can be predictive markers for NPSLE.
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Zandman-Goddard G, Chapman J, Shoenfeld Y (2007) Autoantibodies involved in neuropsychiatric SLE and antiphospholipid syndrome. Semin Arthritis Rheum 36:297–315
Sanna G, Bertolaccini M, Cuadrado M, Laing H, Khamashta M, Mathieu A et al (2003) Neuropsychiatric manifestations in systemic lupus erythematosus: prevalence and association with antiphospholipid antibodies. J Rheumatol 30:985–992
Avcin T, Benseler S, Tyrrell P, Cucnik S, Silverman E (2008) A followup study of antiphospholipid antibodies and associated neuropsychiatric manifestations in 137 children with systemic lupus erythematosus. Arthritis Rheum 59:206–213
Tan EM, Cohen AS, Fries JF, Masi AT, Mcshane DJ, Rothfield NF et al (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25:1271–1277
Karassa F, Afeltra A, Ambrozic A, Chang DM, Keyser FD, Doria A et al (2006) Accuracy of anti-ribosomal P protein antibody testing for the diagnosis of neuropsychiatric systemic lupus erythematosus: an international meta-analysis. Arthritis Rheum 54:312–324
Rheumatol (1999) The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum 42:599–608
Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R et al (2006) International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 4:295–306
Nojima J, Kuratsune H, Suehisa E, Kitani T, Iwatani Y, Kanakura Y (2004) Strong correlation between the prevalence of cerebral infarction and the presence of anti-cardiolipin/beta2-glycoprotein I and anti-phosphatidylserine/prothrombin antibodies—co-existence of these antibodies enhances ADP-induced platelet activation in vitro. Thromb Haemost 91:967–976
Nojima J, Iwatani Y, Suehisa E, Kuratsune H, Kanakura Y (2006) The presence of anti-phosphatidylserine/prothrombin antibodies as risk factor for both arterial and venous thrombosis in patients with systemic lupus erythematosus. Haematologica 91:699–702
Nojima J, Masuda Y, Iwatani Y, Kuratsune H, Watanabe Y, Suehisa E et al (2008) Arteriosclerosis obliterans associated with anti-cardiolipin antibody/beta2-glycoprotein I antibodies as a strong risk factor for ischaemic heart disease in patients with systemic lupus erythematosus. Rheumatology (Oxford) 47:684–689
Hasegawa M, Sato S, Yanaba K, Komura K, Yamazaki M, Takehara K (2004) Autoantibodies against phosphatidylserine-prothrombin complex in patients with systemic sclerosis. Ann Rheum Dis 63:1514–1517
Hanly J, McCurdy G, Fougere L, Douglas J, Thompson K (2004) Neuropsychiatric events in systemic lupus erythematosus: attribution and clinical significance. J Rheumatol 31:2156–2162
Sibbitt WJ, Brandt J, Johnson C, Maldonado M, Patel S, Ford C et al (2002) The incidence and prevalence of neuropsychiatric syndromes in pediatric onset systemic lupus erythematosus. J Rheumatol 29:1536–1542
Hanly JG, Urowitz MB, Sanchez-Guerrero J, Bae SC, Gordon C, Wallace DJ et al (2007) Neuropsychiatric events at the time of diagnosis of systemic lupus erythematosus: an international inception cohort study. Arthritis Rheum 56:265–273
Khamashta M, Gil A, Anciones B, Lavilla P, Valencia M, Pintado V et al (1988) Chorea in systemic lupus erythematosus: association with antiphospholipid antibodies. Ann Rheum Dis 47:681–683
Ghosh J, Gupta D (2005) Chorea and microphonia as presenting feature of SLE. Indian J Pediatr 72:85
Watanabe T, Onda H (2004) Hemichorea with antiphospholipid antibodies in a patient with lupus nephritis. Pediatr Nephrol 19:451–453
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Syuto, T., Shimizu, A., Takeuchi, Y. et al. Association of antiphosphatidylserine/prothrombin antibodies with neuropsychiatric systemic lupus erythematosus. Clin Rheumatol 28, 841–845 (2009). https://doi.org/10.1007/s10067-009-1123-1
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DOI: https://doi.org/10.1007/s10067-009-1123-1