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Neuropsychiatric manifestations of children and adolescents with juvenile systemic lupus erythematosus: is there an association with antiphospholipid antibodies?

OBJECTIVE: to study the frequency of antiphospholipid antibodies (aPL) in patients with juvenile systemic lupus erythematosus (JSLE) and the possible association to neuropsychiatric manifestations. METHODS: retrospective analysis of charts of 64 JSLE patients according to the American College of Rheumatology (ACR) classification criteria, followed for at least six months. The neuropsychiatric manifestations were defined by the presence of: headache, seizure, cerebrovascular accident (CVA), chorea, medular or peripheral neuropathy and behavior disturbances with psichosis or not. The aPL were tested in two occasions with an interval of two months. Values greater than 20 for IgG or 12 for IgM were considered as positive. The lupus anticoagulant was tested in 32 patients. The statistical analysis was performed using the Fisher’s exact test with a significance level of 0,05. RESULTS: 38 (59.4%) out of 64 JSLE patients had neuropsychiatric manifestations. APL antibodies were presented in 29 patients (45.3%). We did not observe a difference of the aPL antibodies positivity in patients with or without neuropsychiatric manifestations (44.7% x 46%, respectively). The aPL antibodies were positive in three out four patients with CVA and in the three patients with chorea. CONCLUSION: although we have not found a higher frequency of aPL antibodies in patients with neuropsychiatric manifestations, our results showed that an association between the aPL antibodies and chorea or CVA may exist.

systemic lupus erythematosus; antiphospholipid antibodies; neuropsychiatric involvement; children


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