Abstract:
OBJECTIVE:To determine the diagnostic and therapeutic approach used in clinical practice for the management of systemic lupus erythematosus (SLE) patients with primary SLE-mediated neuropsychiatric (NP) manifestations. METHODS:A questionnaire was drawn up to assess how clinicians manage various clinical manifestations of SLE. A portion of this questionnaire was designed to assess how clinicians diagnose and treat primary NP-SLE. Most of the questions in the NP-SLE section consisted of lists of different clinical manifestations and laboratory or radiological studies that participants were asked to rate on a scale of importance [from 1 (extremely important) to 5 (not important)] to the diagnosis of primary NP-SLE. The questionnaire also assessed how different NP manifestations are treated in clinical practice. The relative importance of each clinical manifestation was determined through its mean score, and the agreement among participants on each issue was determined using the coefficient of variation (CV). Fifty-nine lupus centers participated in the NP-SLE portion of the survey. RESULTS:The clinical manifestations which were considered to be of extreme or major importance for the diagnosis of primary NP-SLE were seizures, psychosis, transverse myelitis, stroke, transient ischemic attack (TIA) and aseptic meningitis. Among the radiological and laboratory studies, only brain magnetic resonance imaging (MRI) and antiphospholipid antibodies (aPL) achieved "extremely important" mean scores (between 1 and 2). aPL testing was used routinely in the majority of patients (mean 96.8%; CV = 0.1), while brain MRI was used less frequently (mean 56.5%; CV = 0.61). Only brain MRI and cerebral angiography were considered to be helpful in differentiating cerebral vasculopathy from multi-infarct (mean score = 1.6 and 1.9, respectively), whereas a prompt response to treatment with increased doses of steroids was considered helpful in differentiating SLE-related psychosis from steroid-induced psychosis (mean score = 1.58). The results of aPL testing, coagulation tests for the lupus anticoagulant, an brain MRI were considered to be of extreme or major importance in decisions involving treatment with anticoagulant or anti-platelet therapy. Symptomatic therapies, such as heparin, or anti-convulsant, anti-platelet, oral anticoagulant, and antipsychotic therapy were the most widely used. Corticosteroids were the most frequently used immunosuppressive therapy. The administration of other immunosuppressive agents as specific treatment for NP-SLE was uncommon. CONCLUSIONS:Our survey found that in clinical practice, the NP manifestations currently considered to be diagnostic of primary SLE-mediated CNS involvement are not limited to those included in the American Rheumatism Association (ARA) criteria, e.g. seizures and psychosis. Antiphospholipid antibodies appeared to be the laboratory parameter most frequently relied upon in the diagnosis of NP-SLE, and in decisions regarding treatment. Apart from that, only brain MRI and, in selected cases, cerebral angiography seemed to be of real help in diagnosis. The lack of consensus regarding the treatment of primary NP-SLE manifestations most probably reflects both the complex nature of neurological illness in SLE patients and the lack of clear diagnostic criteria.
journal_name
Clin Exp Rheumatoljournal_title
Clinical and experimental rheumatologyauthors
Tincani A,Brey R,Balestrieri G,Vitali C,Doria A,Galeazzi M,Meroni PL,Migliorini P,Neri R,Tavoni A,Bombardieri Ssubject
Has Abstractpub_date
1996-11-01 00:00:00pages
S23-9eissn
0392-856Xissn
1593-098Xjournal_volume
14 Suppl 16pub_type
杂志文章,多中心研究abstract::There is general agreement that the hepatitis C virus is efficiently transmitted parenterally, while data on viral transmission from mothers to babies or by sexual or non-sexual household contact are conflicting. In Italy, hepatitis C accounts for approximately 20% of all cases of acute viral hepatitis. It is more fre...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVES:To evaluate the efficacy of etoricoxib in patients with axial ankylosing spondyloarthritis (AS) refractory to traditional NSAIDs. METHODS:This was an open label, multicentric, randomised, prospective (4 weeks with and open extension to 6 months), non-controlled study. Consecutive patients with axial AS refr...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVES:To compare the diagnostic performance between a vascular specialist and a rheumatologist not familiar with vascular ultrasound when applying the compression sign for the diagnosis of temporal arteritis. METHODS:Sixty consecutive patients with suspicion of giant cell arteritis were examined by both examiners...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVES:Various cancer studies have suggested that polymorphism of GSTM1 may influence the ability to detoxify chemicals in cigarette smoke. In the present study the effect of smoking on clinical features of Behçet's disease were investigated in patients having GST-M1 and/or -T1 null polymorphisms. METHODS:Ninety-s...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2012-05-01 00:00:00
abstract::It is recognised that the genetic profiles that give rise to chronic inflammatory diseases, under the influence of environmental agents, might have been implicated in the host defence mechanism against lethal infections in the past. Behçet's disease (BD) is an immune-mediated inflammatory disease, expressed as vasculi...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2014-07-01 00:00:00
abstract::This review considers the epidemiological aspects of the genetic investigation of rheumatoid arthritis (RA). Problems both of disease definition and disease heterogeneity render studies difficult to undertake and interpret. The selection of individuals both in population and family studies can explain divergent result...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:1992-05-01 00:00:00
abstract:OBJECTIVES:Various complaints of patients with fibromyalgia often resemble clinical features observed in patients with hypothalamic-pituitary diseases. The aim of this study was to evaluate whether patients with hypothalamic-pituitary diseases are at increased risk for fibromyalgia syndrome (FMS). METHODS:A questionna...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVES:To develop and test a new multidimensional questionnaire for assessment of children with auto-inflammatory disease (AID) such as FMF, PFAPA, HIDS, TRAPS in standard clinical care. METHODS:The juvenile auto-inflammatory disease multidimensional assessment report (JAIMAR) includes 16 parent or patient-centere...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2016-09-01 00:00:00
abstract::Prostaglandin (PG)E2, cyclic adenosine monophosphate (cAMP), white blood cells (WBC), total protein (TP), total complement activity (CH50) and beta-2-microglobulin (beta-2-m) were measured at baseline and after eight days in the synovial fluid (SF) of 16 patients affected with knee-joint effusion due to various arthro...
journal_title:Clinical and experimental rheumatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1989-05-01 00:00:00
abstract::Intercellular adhesion molecule-1 (ICAM-1) is a membrane-bound molecule that is primarily involved in cell-cell adhesive interactions of the immune system. The levels of soluble ICAM-1 (s-ICAM-1) shed into the circulation were studied in the sera of patients with systemic lupus erythematosus (SLE) by an enzyme linked ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVES:Autonomic dysfunction (AD) has been described in various chronic inflammatory diseases. Studies of AD in patients with familial Mediterranean fever (FMF) are inconclusive. We aimed to assess AD in a cohort of FMF patients. METHODS:Signs and symptoms of AD were investigated in patients with FMF and compared ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To search for molecular evidence of Chlamydial infection in systemic lupus erythematosus (SLE) subjects and to assess if there is an association of this infectious agent with coronary artery calcification (CAC), a marker of total atherosclerotic burden. METHODS:28 SLE subjects had blood samples drawn and DNA...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVE:Pulmonary involvement is a common finding in adults with systemic lupus erythematosus (SLE). The aim of this study was to investigate the frequency of pulmonary abnormalities in patients with childhood-onset SLE, with particular reference to interstitial lung disease (ILD), and to examine any association betw...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2006-03-01 00:00:00
abstract::Immunochemical study of the cryoglobulins has produced a classification of three main types which present clinical correlates. With the current standard immunofixation technique the vast majority of cryoglobulins are presently classified as type II. High-resolution immunoelectrophoretic techniques (immunoblotting and ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:1995-11-01 00:00:00
abstract::Churg Strauss syndrome (CSS) may lead to cardiac involvement in up to 60% of patients. The myocardium, coronary vasculature, valves and pericardium may be affected. This results in significant morbidity and mortality, accounting for 48% of deaths due to CSS. Cardiac magnetic resonance imaging (CMR) is used to evaluate...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2004-01-01 00:00:00
abstract::The unusual occurrence of cranial (trigeminal) and peripheral neuropathy in a case of progressive systemic sclerosis (PSS) is described. The possible association of PSS with silicosis is also discussed. ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1987-10-01 00:00:00
abstract::Pain is one of the most frequent clinical symptoms encountered by orthopaedic surgeons and rheumatologists as it is one of the main reasons for patients seeking medical help. Traumas and/or inflammatory rheumatologic diseases give rise to two different types of acute pain, but their chronic evolution is so similar tha...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:Giant cell arteritis (GCA) has a variable course. We assessed whether intensity of initial systemic inflammatory response (ISIR) can predict the course of GCA. METHODS:Charts of 130 GCA patients were reviewed. ISIR intensity at presentation was determined by 5 parameters of inflammation: sedimentation rate >...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVES:The aims of the study were to assess the efficacy of a multicomponent intervention and evaluate the feasibility and user acceptance of an internet-based home telemedical surveillance system for the evaluation of pain and other key health outcomes in patients with fibromyalgia (FM). METHODS:The study involve...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2015-01-01 00:00:00
abstract::Fibromyalgia (FM) is a common syndrome characterised by widespread pain and at least 11/18 painful tender points that requires multimodal pharmacological treatment also combined with non-pharmacological therapy. Various drugs currently are available to control the complex and different symptoms reported by patients. O...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess T cell receptor V beta-gene expression in the peripheral blood and synovial fluid of rheumatoid arthritis patients. METHODS:Cytometric analysis was performed on peripheral blood and synovial fluid lymphocytes from 12 patients using a restricted set of V beta-specific monoc...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVES:Defining predictors of damage would improve patient care. We applied damage indexes to patients with familial Mediterranean fever (FMF) and identified the predictors of damage. METHODS:This is a cross-sectional analysis of 926 FMF patients, who fulfilled the Tel-Hashomer criteria and had at least six months...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:Although oligoarticular juvenile idiopathic arthritis (oJIA) is considered to carry the best prognosis among the JIA subtypes, many children evolve to a chronic course. A few studies have identified clinical risk factors for disease extension, and recent studies have evaluated synovial fluid markers. However...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2011-07-01 00:00:00
abstract::Polyarteritis nodosa (PAN) of the calf muscles is a rare form of vasculitis. We present two cases of PAN limited to the calf and a review of the literature, based on a MEDLINE (PubMed) search of the English literature from 1980 to 2005, using the key words "vasculitis restricted to limbs", "polyarteritis nodosa", and ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract::Rheumatoid arthritis (RA) is an autoimmune inflammatory disease associated with rapid loss of function and radiographic damage. Treatment is targeted to achieve low disease activity/remission, as measured by various pooled indices comprised of laboratory measures, patient-derived, and physician-derived measures. Outsi...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2014-09-01 00:00:00
abstract::The M.D.R. index is a new instrument which has been designed to give a measurement of physical function in inflammatory joint disease. It is very easy to apply and is not time-consuming. In preliminary assessment, the index has proven to be highly reliable. It has also been sufficiently sensitive to detect short-term ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1985-10-01 00:00:00
abstract::Pulmonary hemorrhage (PH) is a rare but potentially life-threatening manifestation of systemic lupus erythematosus (SLE). In this report we describe a 13 year old girl with PH as the sole presenting clinical manifestation of her SLE. Her serology was diagnostic of SLE and one year after presentation she developed arth...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1997-11-01 00:00:00
abstract::Fasting hypergastrinemia was noted in 13-41% of 82 of outpatients with definite or classical rheumatoid arthritis. No differences were noted between the normogastrinemic and the hypergastrinemic subjects in their age, sex, duration of rheumatoid disease, serological status, or medications. The food-stimulated gastrin ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::An infant with erythematous rash born from a mother with silicone breast implants is described. The diagnosis of possible neonatal lupus was suggested based on the presence of the skin rash and positive Ro/SS-A antibodies in the infant and positive ANA and Ro/SS-A in the mother. ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVES:We evaluated age at natural menopause and the prevalence of premature ovarian failure (POF) in a monocentric Caucasian cohort of patients with systemic lupus erythematosus (SLE). METHODS:In this cross-sectional study, we enrolled women affected by SLE compared with healthy controls (HC) to investigate data ...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2020-05-01 00:00:00