Neuropsychic manifestations in the Kyrgyz cohort of patients with systemic lupus erythematosus

The aimof the investigation was to study neuropsychic manifestations (NPM) of systemic lupus erythematosus (SLE) in the Kyrgyz cohort of patients.Material and methods.The prospective study included 460 patients with a reliable diagnosis of SLE, verified according to the diagnostic criteria ACR (1997) and SLICC (2012), observed in the clinic of the Academician M. Mirrakhimov National Center of Cardiology and Therapy from january 2012 to december 2017. Signs of nervous system damage were revealed in 103 (22.39%) of 460 patients with SLE. Classification criteria of ACR (1999) were used to assess neuropsychic manifestations of SLE, which were diagnosed by the psychiatrist according to ICD-10. Cognitive disorders were detected by a psychologist using a specific test Mini-Mental State Examination (MMSE; mini-scheme study of the mental state of the patient).Results and discussion.Various signs of NPM SLE were revealed in 103 (22.39%) of 460 patients with SLE. Groups of patients with and without NPM SLE at the beginning of the study were comparable in age, time from the appearance of the first signs of SLE to the verification of the diagnosis and the value of the SLEDAI-2K index (p>0.05). Acute variant of SLE course was significantly associated with NPM SLE. The acute course of SLE was observed in 56 (54.38%) of the 103 patients with NPM SLE and 109 (30.53%) of the 357 patients without NPM SLE [odds ratio (OR) 2.71, 95% confidence interval (CI) of 1.73–4.24; pConclusion.NPM SLE was identified in 22.39% of patients. Acute variant of SLE and very high activity was associated with NPM SLE. The risk of NPM SLE developing in very high activity of SLE was increased by 5.75 times. In the vast majority of cases in Kyrgyz patients there was CNS involvement (68.93%), twice less – PNS damage (31.07%), combined lesion of PNS and CNS was noted less frequently (3.88%). 47.89% of patients had more than one manifestation of NPM SLE. In most patients with diffuse NPM SLE, psychosis was observed in the form of visual and auditory hallucinations (72.34%), and focal ones were presented by CVD (43.42%), usually in the form of discirculatory encephalopathy (90.91%).