Abstract

Systemic lupus erythematosus (SLE) is a rare autoimmune/inflammatory disease with significant morbidity and mortality. Approximately 15–20% of SLE patients develop the disease during childhood or adolescence (juvenile-onset SLE/jSLE). Patients with jSLE exhibit more variable and severe disease when compared to patients with disease-onset during adulthood. Neuropsychiatric (NP) involvement is a clinically heterogenous and potentially severe complication. Published reports on the incidence and prevalence of NP-jSLE are scarce, and the exact pathophysiology is poorly understood.

This manuscript provides a review of the existing literature, suggesting NP involvement in 13.5–51% of jSLE patients. Among patients with NP-jSLE affecting the CNS, we propose two main subgroups: (i) a chronic progressive, predominantly type 1 interferon-driven form that poorly responds to currently used treatments, and (ii) an acutely aggressive form that usually presents early during the disease that may be primarily mediated by auto-reactive effector lymphocytes. While this hypothesis requires to be tested in large collaborative international cohort studies, it may offer future patient stratification and individualised care.

Details

Title
Neuropsychiatric involvement in juvenile-onset systemic lupus erythematosus (jSLE)
Author
Natoli, Valentina 1 ; Charras, Amandine 2 ; Hahn, Gabriele 3 ; Hedrich, Christian M. 4 

 Institute of Life Course and Medical Sciences, University of Liverpool, Department of Women’s and Children’s Health, Liverpool, UK (GRID:grid.10025.36) (ISNI:0000 0004 1936 8470); Institute in the Park, Alder Hey Children’s NHS Foundation Trust, Department of Rheumatology, Liverpool, UK (GRID:grid.417858.7) (ISNI:0000 0004 0421 1374); Università degli Studi di Genova, Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili, Genoa, Italy (GRID:grid.5606.5) (ISNI:0000 0001 2151 3065) 
 Institute of Life Course and Medical Sciences, University of Liverpool, Department of Women’s and Children’s Health, Liverpool, UK (GRID:grid.10025.36) (ISNI:0000 0004 1936 8470) 
 Universitätsklinikum Carl Gustav Carus, Dresden University of Technology, Department of Radiology, Dresden, Germany (GRID:grid.412282.f) (ISNI:0000 0001 1091 2917) 
 Institute of Life Course and Medical Sciences, University of Liverpool, Department of Women’s and Children’s Health, Liverpool, UK (GRID:grid.10025.36) (ISNI:0000 0004 1936 8470); Institute in the Park, Alder Hey Children’s NHS Foundation Trust, Department of Rheumatology, Liverpool, UK (GRID:grid.417858.7) (ISNI:0000 0004 0421 1374) 
Pages
5
Publication year
2023
Publication date
Dec 2023
Publisher
Springer Nature B.V.
e-ISSN
21947791
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2848015857
Copyright
© The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.