Skip to main content

Main menu

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • Audiovisual Rheum
    • 50th Volume Reprints
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Privacy/GDPR Policy
    • Accessibility
  • Contact Us
  • JRheum Supplements
  • Services

User menu

  • My Cart
  • Log In

Search

  • Advanced search
The Journal of Rheumatology
  • JRheum Supplements
  • Services
  • My Cart
  • Log In
The Journal of Rheumatology

Advanced Search

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • Audiovisual Rheum
    • 50th Volume Reprints
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Privacy/GDPR Policy
    • Accessibility
  • Contact Us
  • Follow Jrheum on BlueSky
  • Follow jrheum on Twitter
  • Visit jrheum on Facebook
  • Follow jrheum on LinkedIn
  • Follow jrheum on YouTube
  • Follow jrheum on Instagram
  • Follow jrheum on RSS
LetterCorrespondence

Neuropsychiatric Manifestations of Systemic Lupus Erythematosus

CARLOS ABUD-MENDOZA, DAVID HERRERA-VAN OOSTDAM and MARCO ULISES MARTÍNEZ-MARTÍNEZ
The Journal of Rheumatology February 2013, 40 (2) 204; DOI: https://doi.org/10.3899/jrheum.121214
CARLOS ABUD-MENDOZA
Regional Unit of Rheumatology and Osteoporosis, Central Hospital Dr. Ignacio Morones Prieto and Faculty of Medicine, Universidad Autónoma de San Luis Potosí, Av. V. Carranza 2395, San Luis Potosí, S.L.P., México, zc 78290.
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: c_abud@hotmail.com
DAVID HERRERA-VAN OOSTDAM
Regional Unit of Rheumatology and Osteoporosis, Central Hospital Dr. Ignacio Morones Prieto and Faculty of Medicine, Universidad Autónoma de San Luis Potosí, Av. V. Carranza 2395, San Luis Potosí, S.L.P., México, zc 78290.
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
MARCO ULISES MARTÍNEZ-MARTÍNEZ
Regional Unit of Rheumatology and Osteoporosis, Central Hospital Dr. Ignacio Morones Prieto and Faculty of Medicine, Universidad Autónoma de San Luis Potosí, Av. V. Carranza 2395, San Luis Potosí, S.L.P., México, zc 78290.
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
  • References
  • PDF
PreviousNext
Loading

To the Editor:

Neuropsychiatric manifestations of systemic lupus erythematosus (NPSLE) are responsible for high rates of morbidity and mortality. Zirkzee, et al1 emphasize the importance of ascertaining the different NPSLE phenotypes, which could be helpful in making potential therapeutic decisions. However, it is evident that there were patients who had both profiles described by the authors, that is, inflammatory and ischemic. Because of such overlapping of severe NPSLE manifestations, we consider that physicians must keep in mind starting therapy for both patterns while waiting to define the pathogenesis of the neurological expression. It is evident that high disease activity represents one of the most important risk factors for developing NPSLE, as obtained using the Systemic Lupus Erythematosus Disease Activity Index, and it includes NPSLE manifestations as the main factor. We consider that the study by Zirkzee, et al could have incorporated other biomarkers suggested by some algorithms, and lumbar puncture has been suggested as a diagnostic approach2 that could help in excluding other involved factors besides SLE activity, such as infections. Recently, it has been reported that positron emission tomography scanning is more sensitive than magnetic resonance imaging (MRI)3; although Zirkzee, et al reported 100% sensitivity of MRI, this sensitivity is lower when there is no focal neurological deficit related to NPSLE, as described in some cases of small-vessel central nervous system angiitis, as well as other manifestations4. Moreover, conventional MRI may present limitations in interpretation because lesions may be acute and/or chronic5, and we recognize that MRI studies should include special techniques (e.g., diffusion and metabolites).

REFERENCES

  1. 1.↵
    1. Zirkzee EJ,
    2. Steup-Beekman GM,
    3. van der Mast RC,
    4. Bollen EL,
    5. van der Wee NJ,
    6. Baptist E,
    7. et al.
    Prospective study of clinical phenotypes in neuropsychiatric systemic lupus erythematosus; multidisciplinary approach to diagnosis and therapy. J Rheumatol 2012;39:2118–26.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    1. Bertsias GK,
    2. Boumpas DT
    . Pathogenesis, diagnosis and management of neuropsychiatric SLE manifestations. Nat Rev Rheumatol 2010;6:358–67.
    OpenUrlCrossRefPubMed
  3. 3.↵
    1. Lee SW,
    2. Park MC,
    3. Lee SK,
    4. Park YB
    . The efficacy of brain 18F-fluorodeoxyglucose positron emission tomography in neuropsychiatric lupus patients with normal brain magnetic resonance imaging findings. Lupus 2012 Aug 31. [E-pub ahead of print]
  4. 4.↵
    1. Cellucci T,
    2. Tyrrell PN,
    3. Sheikh S,
    4. Benseler SM
    . Childhood primary angiitis of the central nervous system: Identifying disease trajectories and early risk factors for persistently higher disease activity. Arthritis Rheum 2012;64:1665–72.
    OpenUrlCrossRefPubMed
  5. 5.↵
    1. Peterson PL,
    2. Axford JS,
    3. Isenberg D
    . Imaging in CNS lupus. Best Pract Res Clin Rheumatol 2005;19:727–39.
    OpenUrlCrossRefPubMed
PreviousNext
Back to top

In this issue

The Journal of Rheumatology
Vol. 40, Issue 2
1 Feb 2013
  • Table of Contents
  • Table of Contents (PDF)
  • Index by Author
  • Editorial Board (PDF)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about The Journal of Rheumatology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Neuropsychiatric Manifestations of Systemic Lupus Erythematosus
(Your Name) has forwarded a page to you from The Journal of Rheumatology
(Your Name) thought you would like to see this page from the The Journal of Rheumatology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Neuropsychiatric Manifestations of Systemic Lupus Erythematosus
CARLOS ABUD-MENDOZA, DAVID HERRERA-VAN OOSTDAM, MARCO ULISES MARTÍNEZ-MARTÍNEZ
The Journal of Rheumatology Feb 2013, 40 (2) 204; DOI: 10.3899/jrheum.121214

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

 Request Permissions

Share
Neuropsychiatric Manifestations of Systemic Lupus Erythematosus
CARLOS ABUD-MENDOZA, DAVID HERRERA-VAN OOSTDAM, MARCO ULISES MARTÍNEZ-MARTÍNEZ
The Journal of Rheumatology Feb 2013, 40 (2) 204; DOI: 10.3899/jrheum.121214
del.icio.us logo Twitter logo Facebook logo  logo Mendeley logo
  • Tweet Widget
  •  logo
Bookmark this article

Jump to section

  • Article
    • REFERENCES
  • Info & Metrics
  • References
  • PDF

Related Articles

Cited By...

More in this TOC Section

  • Dr. Yoshida et al reply
  • Application of EULAR/ACR Classification Criteria for Polymyalgia Rheumatica in a Series of Patients With Acute Parvovirus B19 Infection
  • A Rare Case of Parvovirus B19-Induced Atlantoaxial Arthritis
Show more Correspondence

Similar Articles

Content

  • First Release
  • Current
  • Archives
  • Collections
  • Audiovisual Rheum
  • COVID-19 and Rheumatology

Resources

  • Guide for Authors
  • Submit Manuscript
  • Author Payment
  • Reviewers
  • Advertisers
  • Classified Ads
  • Reprints and Translations
  • Permissions
  • Meetings
  • FAQ
  • Policies

Subscribers

  • Subscription Information
  • Purchase Subscription
  • Your Account
  • Terms and Conditions

More

  • About Us
  • Contact Us
  • My Alerts
  • My Folders
  • Privacy/GDPR Policy
  • RSS Feeds
The Journal of Rheumatology
The content of this site is intended for health care professionals.
Copyright © 2025 by The Journal of Rheumatology Publishing Co. Ltd.
Print ISSN: 0315-162X; Online ISSN: 1499-2752
Powered by HighWire