Neurological involvement in patients with systemic autoimmune rheumatic diseases: a descriptive study in an Egyptian cohort
Abstract Background Neurologic manifestations in the systemic autoimmune rheumatic diseases (SARDs) are protean. They add to the disease burden and could contribute to mortality. Increasing awareness about the neuro-rheumatologic syndromes might help with early diagnosis and effective therapy. Our a...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2024-12-01
|
| Series: | The Egyptian Journal of Neurology, Psychiatry and Neurosurgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s41983-024-00918-5 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850257718785343488 |
|---|---|
| author | Doaa Hassan Sayed Attia Alshaimaa Aboul Fotouh Reem Hamdy Abdellatif Mohammed |
| author_facet | Doaa Hassan Sayed Attia Alshaimaa Aboul Fotouh Reem Hamdy Abdellatif Mohammed |
| author_sort | Doaa Hassan Sayed Attia |
| collection | DOAJ |
| description | Abstract Background Neurologic manifestations in the systemic autoimmune rheumatic diseases (SARDs) are protean. They add to the disease burden and could contribute to mortality. Increasing awareness about the neuro-rheumatologic syndromes might help with early diagnosis and effective therapy. Our aim is to survey the clinical and imaging patterns of neurological involvement in Egyptian patients with SARDs. Results Neurological involvement is common in Behçet’s disease (BD) (12.7%) and systemic lupus erythematosus (SLE) (6.4%) patients compared with other SARDs. Compared with SLE, neurological involvement in BD tends to develop at an older age (31 ± 7.1 versus 28.3 ± 9.6 years = 0.022) with a greater progression risk (13.8% versus 2.6%, P = 0.003). A higher proportion of SLE patients had abnormal neuroimaging without neurological symptoms (15.7% versus 4.3%, P = 0.026, OR = 4.9, 95%CI 1.1–22.4). SLE patients had a higher frequency of seizures (31.3% versus 6.4%, P < 0.001, OR = 6.7, 95%CI 2.7–16.7) and benign intracranial hypertension (9.6% versus 1.1%, P = 0.009, OR = 9.8, 95%CI 1.2–77.7) but a lower prevalence of quadriplegia due to brain insult (1.7% versus 3.2%, P = 0.045, OR = 0.2, 95%CI 0.04–0.9), dural sinus thrombosis (13% versus 33%, P = 0.001, OR = 0.3, 95%CI 0.2–0.6), brainstem syndrome (0.9% versus 6.4%, P = 0.047, OR = 0.1, 95%CI 0–1.1) and cranial neuropathies (9.6% versus 31.9%, P < 0.001, OR = 0.2, 95%CI 0.1–0.5). Concerning neuroimaging, brain atrophic changes were more common (27.4% versus 9.5%, P = 0.002, OR = 3.6, 95%CI 1.6–8.3) while thrombosis was less prevalent (36.3% versus 53.6%, P = 0.016, OR 0.5, 95%CI = 0.3–0.9) in lupus patients. The cerebral cortex was more commonly affected (20.4 versus 4.8%, P = 0.002, OR = 5.1, 95%CI 1.7–15.4) while dural sinuses (14.2% versus 40.5%, P < 0.001, OR = 0.2, 95%CI 0.1–0.5), basal ganglia (1.8% versus 10.7%, P = 0.010, OR = 0.2, 95%CI 0–0.7), diencephalon (0% versus 13.1%, P < 0.001) and brainstem (1.8% versus 22.6%, P < 0.001, OR = 0.1, 95%CI 0–0.3) were less frequently involved in SLE patients. Concerning other SARDs, cranial neuropathies were the most common neurological presentations. Abnormalities in neuroimaging did not correlate with the patients’ clinical presentations. Conclusions Neurological presentations associated with SARDs are protean. Neuroimaging abnormalities should be interpreted within the context of the clinical picture and the results of other investigations. |
| format | Article |
| id | doaj-art-1860ef1330f04425b6c74a09ee57a2f0 |
| institution | OA Journals |
| issn | 1687-8329 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Neurology, Psychiatry and Neurosurgery |
| spelling | doaj-art-1860ef1330f04425b6c74a09ee57a2f02025-08-20T01:56:20ZengSpringerOpenThe Egyptian Journal of Neurology, Psychiatry and Neurosurgery1687-83292024-12-0160111710.1186/s41983-024-00918-5Neurological involvement in patients with systemic autoimmune rheumatic diseases: a descriptive study in an Egyptian cohortDoaa Hassan Sayed Attia0Alshaimaa Aboul Fotouh1Reem Hamdy Abdellatif Mohammed2Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University HospitalsNeurology Department, Faculty of Medicine, Cairo University HospitalsRheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University HospitalsAbstract Background Neurologic manifestations in the systemic autoimmune rheumatic diseases (SARDs) are protean. They add to the disease burden and could contribute to mortality. Increasing awareness about the neuro-rheumatologic syndromes might help with early diagnosis and effective therapy. Our aim is to survey the clinical and imaging patterns of neurological involvement in Egyptian patients with SARDs. Results Neurological involvement is common in Behçet’s disease (BD) (12.7%) and systemic lupus erythematosus (SLE) (6.4%) patients compared with other SARDs. Compared with SLE, neurological involvement in BD tends to develop at an older age (31 ± 7.1 versus 28.3 ± 9.6 years = 0.022) with a greater progression risk (13.8% versus 2.6%, P = 0.003). A higher proportion of SLE patients had abnormal neuroimaging without neurological symptoms (15.7% versus 4.3%, P = 0.026, OR = 4.9, 95%CI 1.1–22.4). SLE patients had a higher frequency of seizures (31.3% versus 6.4%, P < 0.001, OR = 6.7, 95%CI 2.7–16.7) and benign intracranial hypertension (9.6% versus 1.1%, P = 0.009, OR = 9.8, 95%CI 1.2–77.7) but a lower prevalence of quadriplegia due to brain insult (1.7% versus 3.2%, P = 0.045, OR = 0.2, 95%CI 0.04–0.9), dural sinus thrombosis (13% versus 33%, P = 0.001, OR = 0.3, 95%CI 0.2–0.6), brainstem syndrome (0.9% versus 6.4%, P = 0.047, OR = 0.1, 95%CI 0–1.1) and cranial neuropathies (9.6% versus 31.9%, P < 0.001, OR = 0.2, 95%CI 0.1–0.5). Concerning neuroimaging, brain atrophic changes were more common (27.4% versus 9.5%, P = 0.002, OR = 3.6, 95%CI 1.6–8.3) while thrombosis was less prevalent (36.3% versus 53.6%, P = 0.016, OR 0.5, 95%CI = 0.3–0.9) in lupus patients. The cerebral cortex was more commonly affected (20.4 versus 4.8%, P = 0.002, OR = 5.1, 95%CI 1.7–15.4) while dural sinuses (14.2% versus 40.5%, P < 0.001, OR = 0.2, 95%CI 0.1–0.5), basal ganglia (1.8% versus 10.7%, P = 0.010, OR = 0.2, 95%CI 0–0.7), diencephalon (0% versus 13.1%, P < 0.001) and brainstem (1.8% versus 22.6%, P < 0.001, OR = 0.1, 95%CI 0–0.3) were less frequently involved in SLE patients. Concerning other SARDs, cranial neuropathies were the most common neurological presentations. Abnormalities in neuroimaging did not correlate with the patients’ clinical presentations. Conclusions Neurological presentations associated with SARDs are protean. Neuroimaging abnormalities should be interpreted within the context of the clinical picture and the results of other investigations.https://doi.org/10.1186/s41983-024-00918-5Connective tissue diseasesNeuroimagingNeurological manifestationsSystemic autoimmune rheumatic diseasesSystemic vasculitides |
| spellingShingle | Doaa Hassan Sayed Attia Alshaimaa Aboul Fotouh Reem Hamdy Abdellatif Mohammed Neurological involvement in patients with systemic autoimmune rheumatic diseases: a descriptive study in an Egyptian cohort The Egyptian Journal of Neurology, Psychiatry and Neurosurgery Connective tissue diseases Neuroimaging Neurological manifestations Systemic autoimmune rheumatic diseases Systemic vasculitides |
| title | Neurological involvement in patients with systemic autoimmune rheumatic diseases: a descriptive study in an Egyptian cohort |
| title_full | Neurological involvement in patients with systemic autoimmune rheumatic diseases: a descriptive study in an Egyptian cohort |
| title_fullStr | Neurological involvement in patients with systemic autoimmune rheumatic diseases: a descriptive study in an Egyptian cohort |
| title_full_unstemmed | Neurological involvement in patients with systemic autoimmune rheumatic diseases: a descriptive study in an Egyptian cohort |
| title_short | Neurological involvement in patients with systemic autoimmune rheumatic diseases: a descriptive study in an Egyptian cohort |
| title_sort | neurological involvement in patients with systemic autoimmune rheumatic diseases a descriptive study in an egyptian cohort |
| topic | Connective tissue diseases Neuroimaging Neurological manifestations Systemic autoimmune rheumatic diseases Systemic vasculitides |
| url | https://doi.org/10.1186/s41983-024-00918-5 |
| work_keys_str_mv | AT doaahassansayedattia neurologicalinvolvementinpatientswithsystemicautoimmunerheumaticdiseasesadescriptivestudyinanegyptiancohort AT alshaimaaaboulfotouh neurologicalinvolvementinpatientswithsystemicautoimmunerheumaticdiseasesadescriptivestudyinanegyptiancohort AT reemhamdyabdellatifmohammed neurologicalinvolvementinpatientswithsystemicautoimmunerheumaticdiseasesadescriptivestudyinanegyptiancohort |