ArticleArthritis research & therapy2019
Clinical features of central nervous system infections and experience in differential diagnosis from neuropsychiatric lupus erythematosus in a cohort of 8491 patients with systemic lupus erythematosus.
Article in Arthritis research & therapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Central nervous system infections in patients with systemic lupus erythematosus: a systematic review and meta-analysis.Lupus science & medicine · 2022Pooled it
- The prevalence and mortality of cryptococcal meningitis in patients with autoimmune diseases: a systematic review and meta-analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021Pooled it
- TSPO PET/MR in neuropsychiatric lupus: neuroinflammatory metabolic signatures and diagnostic biomarkers.Lupus science & medicine · 2025Article
- Epstein-Barr Virus encephalitis associated hemophagocytic lymphohistiocytosis in childhood-onset systemic lupus erythematosus: a case-based review.Pediatric rheumatology online journal · 2024Review
- Topological structural characteristics in patients with systemic lupus erythematosus with and without neuropsychiatric symptoms.Lupus science & medicine · 2024Article
- Inflammatory Disorders of the Central Nervous System Vessels: Narrative Review.Medicina (Kaunas, Lithuania) · 2022Review
- Anti-Ribosomal-P Antibody Association with Neuropsychiatric Lupus in Sudanese Patients Attending Rheumatology Clinic in Omdurman Military Hospital.Open access rheumatology : research and reviews · 2022Article
- Management of Severe Refractory Systemic Lupus Erythematosus: Real-World Experience and Literature Review.Clinical reviews in allergy & immunology · 2021Review
- Emerging Molecular Markers Towards Potential Diagnostic Panels for Lupus.Frontiers in immunology · 2021Review
- Systemic lupus erythematosus: year in review 2019.Chinese medical journal · 2020Review
- Serological comparison of systemic lupus erythematosus with neuropsychiatric lupus using synthetic nucleic acid antigens.Journal of translational autoimmunity · 2020Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundIn clinical practice, discrimination between central nervous system (CNS) infections in patients with systemic lupus erythematosus (SLE) and neuropsychiatric lupus erythematosus (NPSLE) could be urgent and critical yet extremely challenging. Given this, this study aimed to investigate the clinical features and outcomes of infections in the CNS in patients with SLE and to establish a simplified scoring system for guiding the discrimination of CNS infections from NPSLE.
methodsA total of 95 patients who were identified as having CNS infections among 8491 SLE patients between January 1992 and January 2018 were included in this retrospective study. NPSLE patients admitted at the same period were randomly selected for comparison. Key factors either clinically valuable or statistically significant for discriminating CNS infections from NPSLE were integrated to build a simplified scoring system. Another group of 22 SLE patients complicated with suspected newly onset of CNS infections or NPSLE admitted after January 2018 was enrolled to verify the utility of the scoring system.
resultsSixty-three positive pathogens were identified in 59 patients of the total 95 CNS infection cases. Compared with the NPSLE group, the CNS infections group had a longer disease duration (21.0 [3.0-50.0] vs. 1.0 [0-22.0] months, P < 0.05), exhibited more fever (96.8% vs. 23.2%, P < 0.001) and polymorphonuclear leukocyte leukocytosis in the cerebrospinal fluid (CSF) (45.6% vs. 0.5%, P < 0.05), and had significantly decreased CSF glucose (2.0 ± 1.3 vs. 3.3 ± 0.9 mmol/L, P < 0.01), whereas hypocomplementemia seemed to be a strong hint of NPSLE (44.6% vs. 77.4%, P < 0.001). A simplified scoring system integrated with 8 key factors was established for guiding clinical differential diagnosis. By setting the cutoff value at 4 and verifying in a group of SLE patients complicated with newly occurred suspected CNS infection or NPSLE, a sensitivity of 85.7% and specificity of 93.3% with the area under the curve (AUC) being 0.93 (95%CI 0.80-1.00) were obtained.
conclusionsCNS infections are a fatal complication of SLE and can be difficult to discriminate from NPSLE. A simplified scoring system may help to make preliminary discrimination of CNS infections from NPSLE.
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