Abstract
Lupus erythematosus is a systemic autoimmune disease with unknown etiology that mainly affects women aged 20-50 years and it can have very different clinical manifestations. Cognitive deficit is one of the most prevalent neuropsychiatric syndromes in lupus erythematosus, but a specific profile was never described for it. There are difficulties in the assessment process due to the variability of clinical symptoms and tools limitations. Neuroi-maging and neuropsychological examination are recommended to assess cognitive impairment. The evolution and treatment (pharmacological and cognitive rehabilitation) are influenced by etiology.
Case: Woman (54 years) diagnosed with lupus erythematosus who was sent to a neuropsychological study due to her concentration and short-term memory problems. She showed alteration in neuroimaging studies, but she maintains personal autonomy.
Conclusion: screening tests of cognitive impairment present reliability controversial for people with lupus erythematosus. An extensive neuropsychological assessment is necessary, including cognitive performance and functionality. Cognitive Impairment are varied, and the course and treatment depend on the etiology (primary vs. secondary).
References
León T, Henríquez C, Calderón J y Massardo L. Actualización en lupus neuro-psiquiátrico con énfasis en el déficit cognitivo. Rev Med Chile. 2012;140:1222-341.
Pedroza NJ, Ortiz BL y Vásquez GM. Biomarcadores proteicos en lupus neuropsiquiátrico. Rev Col Reumatol. 2012;19,3:158-71.
Barbosa R, Postal M, Lavras LT, Cendes F y Appenzeller S. Cognitive impairment in Systemic Lupus Erythematosus: Prevalence and clinical importance. Curr Rheumatol Rev 2012;8(1):56-65.
Tsokos G. Systemic Lupus Erythematosus: Basic, Applied and Clinical Aspects. London: Elsevier 2016.p:4-6.
Cervera R, Espinosa G, Ramos-Casals M, Hernández-Rodríguez J y Cid MC. Enfermedades autoinmunes: diagnóstico y tratamiento. Madrid: Editorial Médica Panamericana;2015.p:1-27.
Shehata GA, Elserogy Y, Ahmad H, Abdel-Kareem ML, Al-kabeer AM, Rayan MM, et al. Multimodal neurophyshiological and psychometric evaluation among patients with systemic lupus erythematosus. Int J Gen Med. 2011;4:25-32.
Calderón J, Flores P, Aguirre JM, Valdivia G, Padilla O, Barra I, et al. Impact of cognitive impairment, depression, disease activity, and disease damage on quality of life in women with systemic lupus erythematosus. Scand J Rheumatol. 2016;1-8.
Tani C, Palagini L, Moraes-Fontes MF, Carli L, Mari M, Bombardieri S, et al. Neuropsychiatric questionnaires in systemic lupus erythematosus. Clin Exp Rheumatol. 2014;32(suppl.85):59-64.
Harboe E, Tjensvoll AB, Maroni S, Geransson LG, Greve OJ, Beyer MK, et ál. Neuropsychiatric syndromes in patients with systemic lupus erythematosus and primary Sjogren syndrome: a comparative population-based study. Ann Rheum Dis. 2009;68(10): 1541-46.
Meszaros ZS, Perl A y Faraone SV. Psychiatric symptoms in systemic lupus erythematosus: a systematic review. J Clin Psychiatry. 2012;73(7):993-1001.
Waterloo K, Omdal R, Mellgren SL y Husby G. Neuropsy-chological functions in systemic lupus Erythematosus: A comparison with chronic whiplash patients. Eur J Neurol. 1997;4(2):171-77.
American College of Rheumatology. The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum. 1999;42(4):599-08.
Langenbahn D, Ashman T, Canto y Trott C. Arch Phys Med Rehabil. 2013;94(2):271-86.
Skeel RL, Johnstone B, Yangco DT, Walker SE y Komatireddy GR. Neuropsychological Deficit Profiles in Systemic Lupus Erythematosus. Appl Neuropsychol. 2000;7(2):96-101.
Liang, M. H., Corzillius, M., Bae, S. C., Lew, R. A., Fortin, P. R., Gordon, C & Denburg, S. The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum.1999;42(4):599-608.
Zúñiga Y. Aspectos neurológicos en pacientes pediátricos con Lupus Eritematoso Sistémico / Neuropsychological manifestations in pediatric patients with Systemic Lupus Erythematosus. Acta Neurol Colom. 2014;30(f):49-56.
Hanly JG, Su L, Omisade A, Farewell VT y Fisk JD. Screening for cognitive impairment in systemic lupus erythematosus. J Rheumatol. 2012;39(7):1371-77.
Abda EA, Selim ZI, Radwan ME, Mahmoud NM, Herdan OM, Mohamad KA, et al. Makers of acute neuropsychiatric systemic lupus erythematosus: a multidisciplinary evaluation. Rheumatol Int. 2013;33(5):1243-53.
Mani A, Shenavandeh S, Sepehrtaj SS y Javadpour A. Memory and learning functions is patients with systemic lupus erythe-matosus: A neuropsychological case-control study. Egyptian Rheumatologist. 2015;37(4):13-17.
Kozora E, Elliso MC y West S. Depression, fatigue, and pain in systemic lupus erythematosus (SLE): Relationship to the American College of Rheumatology SLE neuropsychological battery. Arthritis Care Res. 2006;55(4):628-35.
Rey A. Test de copia de una figura compleja. Madrid: TEA Ediciones; 1987.
Artiola i Fortuny L, Hermosillo RD, Heaton RK y Pardee RE. Manual de normas y procedimientos para la bateria neuropsi-cologica en español. Tucson, AZ; Press 1999.
Tamayo F, Casals-Coll M, Sánchez-Benavides G, Quintana M, Manero, RM, Rognoni T, et al. Estudios normativos españoles en población adulta joven (Proyecto NEURONORMA jóvenes): normas para las pruebas span verbal, span visuoespa-cial, Letter-Number Sequencing, Trail Making Test y Symbol Digit Modalitiest Test. Neurología. 2012;27(6):319-29.
Weschler, D. Escala de memoria de Wechsler-III. Manual de aplicación y puntuación. Madrid: TEA Ediciones; 2004.
Wechsler D. Escala de Inteligencia Wechsler para Adultos: WAIS-III. Madrid: TEA Ediciones; 1999.
Lobo A, Sanz P, Marcos G, Grupo de Trabajo ZARADEMP. MMSE: Examen Cognoscitivo Mini-Mental. Madrid: TEA; 2002.
Kozora E, Arciniegas DB, Zhang L y West S. Neuropsycho-logical patterns in systemic lupus erythematosus patients with depression. Arthritis Res Ther, 2007;9(3):48.
Beck AT, Steer RA y Brown GK. Manual. BDI-II. Inventario de Depresión de Beck-II (Adaptación española: Sanz, J., y Vázquez, C.). Madrid:Pearson; 2011.
Golden CJ. STROOP. Test de colores y palabras. Madrid; TEA: 2005.
Goodglass H y Kaplan E. Boston. Evaluación de la Afasia y de Trastornos relacionados. Madrid; TEA Ediciones: 1986.
Isaacs B y Akhtar AJ. The Set Test: a rapid test of mental function in old people. Age Agein; 1972(4):222-26.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.