Background:

Systemic lupus erythematosus (SLE) can affect the nervous system and present a variety of neurological and psychiatric syndromes but the prevalence of neuropsychiatric manifestations in Colombia is unknown.

Methods:

Cross-sectional study. Patients were assessed by the department of rheumatology between 2010 and 2013 and included randomly chosen subjects over 18 years of age. Prevalence of neurological manifestations was calculated using a confidence interval of 95%. SLE disease activity index was used as baseline to compare statistically with activity, neurological manifestations and fatality. Mann-Whitney U test was used for quantitative variables, while chi-square test was used for qualitative variables.

Results:

306 subjects initially entered into the study, 274 were analyzed, 89.1% were women with a median age of 43 years (interquartile range: 23). Prevalence of neuropsychiatric manifestations was 26.2% (95% CI: 21.2-31%). The most common symptoms were headache (13.1%; 95% CI: 9.1-17.2%), cerebrovascular disease (8%; 95% CI: 5.1-11.3%), acute confusional state (6.6%; 95% CI: 4-9.1%), seizure disorders (4.7%; 95% CI: 2.6-7.3%), and aseptic meningitis (2.2%; 95% CI: 0.7-4%); autonomic neuropathy, polyneuropathy, and myelopathy each occurred at 0.7% (95% CI: 0-1.8%). Patients with neuropsychiatric manifestations had severe disease activity (45.8%) and (31.9%) had moderate disease activity.

Conclusions:

In hospitalized patients diagnosed with SLE, NPS manifestations can occur in up to 26% of cases, the most frequent being headache, cerebrovascular disease, acute confusional state, seizures, and aseptic meningitis and the most frequent treatment being systemic steroids. Prospective studies are required to determine their prognostic implications in this group of patients.

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