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Seizure disorders in systemic lupus erythematosus results from an international, prospective, inception cohort study.


ABSTRACT: The aim of this study was to describe the frequency, attribution, outcome and predictors of seizures in systemic lupus erythematosus (SLE).The Systemic Lupus International Collaborating Clinics, or SLICC, performed a prospective inception cohort study. Demographic variables, global SLE disease activity (SLE Disease Activity Index 2000), cumulative organ damage (SLICC/American College of Rheumatology Damage Index (SDI)) and neuropsychiatric events were recorded at enrolment and annually. Lupus anticoagulant, anticardiolipin, anti-?(2) glycoprotein-I, antiribosomal P and anti-NR2 glutamate receptor antibodies were measured at enrolment. Physician outcomes of seizures were recorded. Patient outcomes were derived from the SF-36 (36-Item Short Form Health Survey) mental component summary and physical component summary scores. Statistical analyses included Cox and linear regressions.The cohort was 89.4% female with a mean follow-up of 3.5±2.9 years. Of 1631 patients, 75 (4.6%) had ?1 seizure, the majority around the time of SLE diagnosis. Multivariate analysis indicated a higher risk of seizures with African race/ethnicity (HR (CI): 1.97 (1.07 to 3.63); p=0.03) and lower education status (1.97 (1.21 to 3.19); p<0.01). Higher damage scores (without neuropsychiatric variables) were associated with an increased risk of subsequent seizures (SDI=1:3.93 (1.46 to 10.55); SDI=2 or 3:1.57 (0.32 to 7.65); SDI?4:7.86 (0.89 to 69.06); p=0.03). There was an association with disease activity but not with autoantibodies. Seizures attributed to SLE frequently resolved (59/78 (76%)) in the absence of antiseizure drugs. There was no significant impact on the mental component summary or physical component summary scores. Antimalarial drugs in the absence of immunosuppressive agents were associated with reduced seizure risk (0.07 (0.01 to 0.66); p=0.03).Seizures occurred close to SLE diagnosis, in patients with African race/ethnicity, lower educational status and cumulative organ damage. Most seizures resolved without a negative impact on health-related quality of life. Antimalarial drugs were associated with a protective effect.

SUBMITTER: Hanly JG 

PROVIDER: S-EPMC4656036 | biostudies-literature | 2012 Sep

REPOSITORIES: biostudies-literature

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Seizure disorders in systemic lupus erythematosus results from an international, prospective, inception cohort study.

Hanly John G JG   Urowitz Murray B MB   Su Li L   Gordon Caroline C   Bae Sang-Cheol SC   Sanchez-Guerrero Jorge J   Romero-Diaz Juanita J   Wallace Daniel J DJ   Clarke Ann E AE   Ginzler Em E   Merrill Joan T JT   Isenberg David A DA   Rahman Anisur A   Petri M M   Fortin Paul R PR   Gladman Dd D   Bruce Ian N IN   Steinsson Kristjan K   Dooley Ma M   Khamashta Munther A MA   Alarcón Graciela S GS   Fessler Barri J BJ   Ramsey-Goldman Rosalind R   Manzi Susan S   Zoma Asad A AA   Sturfelt Gunnar K GK   Nived Ola O   Aranow Cynthia C   Mackay Meggan M   Ramos-Casals Manuel M   van Vollenhoven Rf R   Kalunian Kenneth C KC   Ruiz-Irastorza Guillermo G   Lim Sam S   Kamen Diane L DL   Peschken Christine A CA   Inanc Murat M   Theriault Chris C   Thompson Kara K   Farewell Vernon V  

Annals of the rheumatic diseases 20120404 9


<h4>Objective</h4>The aim of this study was to describe the frequency, attribution, outcome and predictors of seizures in systemic lupus erythematosus (SLE).<h4>Methods</h4>The Systemic Lupus International Collaborating Clinics, or SLICC, performed a prospective inception cohort study. Demographic variables, global SLE disease activity (SLE Disease Activity Index 2000), cumulative organ damage (SLICC/American College of Rheumatology Damage Index (SDI)) and neuropsychiatric events were recorded a  ...[more]

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