Abstract
Background: Central nervous system manifestation of systemic lupus erythematosus (CNS-SLE) is a common complication, which is clinically associated with patient morbidity and mortality
Objective: To determine the CNS-SLE manifestations and to determine the predictors of death among the studied cohort
Design: Retrospective
Setting: King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
Subjects: All patients diagnosed with SLE were identified, using a computerized retrieval system, for the period January 1, 2000 to May 31, 2012.
Intervention(s): Data pertaining to demographics, risk factors for cerebrovascular accident and CNS manifestations were collected from the patients' medical charts
Main Outcome Measure(s): CNS-SLE and the predictors of death among the studied cohort
Results: 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.
Conclusions: 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.