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Neurological Complications in Patients with Systemic Lupus Erythematosus

  • Neurology of Systemic Diseases (J Biller, Section Editor)
  • Published:
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Abstract

Purpose of Review

Systemic lupus erythematosus (SLE) is commonly associated with neurological manifestations. Rapid recognition and treatment of these complications may improve outcomes. In this article, we review the neurological conditions associated with SLE, their diagnosis and management strategies.

Recent Findings

Recent meta-analysis showed that patients with neuropsychiatric manifestations of SLE were more likely to have positive antiphospholipid, antiribosomal P, and antineuronal antibodies. Another meta-analysis showed an association between SLE and antiphospholipid antibodies with cognitive impairment. Two large retrospective studies have shown that the peripheral nervous system is commonly involved in SLE frequently alongside the central nervous system.

Summary

Neurological manifestations occur in most of SLE patients. Antiphospholipid antibodies are common in patients with SLE and increase the odds of neurological complications. Management typically involved a combination of treatments directed toward the neurological complication and therapies directed toward SLE itself. The efficacy of these treatment protocols, however, has not been rigorously studied and deserves further investigation.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Muscal E, Brey RL. Neurologic manifestations of systemic lupus erythematosus in children and adults. Neurol Clin. 2010;28(1):61–73.

    PubMed  PubMed Central  Google Scholar 

  2. Danchenko N, Satia JA, Anthony MS. Epidemiology of systemic lupus erythematosus: a comparison of worldwide disease burden. Lupus. 2006;15(5):308–18.

    PubMed  CAS  Google Scholar 

  3. Brey RL, Holliday SL, Saklad AR, Navarrete MG, Hermosillo-Romo D, Stallworth CL, et al. Neuropsychiatric syndromes in lupus: prevalence using standardized definitions. Neurology. 2002;58(8):1214–20.

    PubMed  CAS  Google Scholar 

  4. Sibbitt WL Jr, Brandt JR, Johnson CR, Maldonado ME, Patel SR, Ford CC, et al. The incidence and prevalence of neuropsychiatric syndromes in pediatric onset systemic lupus erythematosus. J Rheumatol. 2002;29(7):1536–42.

    PubMed  Google Scholar 

  5. Yu HH, Lee JH, Wang LC, Yang YH, Chiang BL. Neuropsychiatric manifestations in pediatric systemic lupus erythematosus: a 20-year study. Lupus. 2006;15(10):651–7.

    PubMed  CAS  Google Scholar 

  6. • The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum. 1999;42(4):599-608. This article introduced and defined the currently used nomenclature for neurological complications of systemic lupus erythematosus.

  7. Futrell N, Millikan C. Frequency, etiology, and prevention of stroke in patients with systemic lupus erythematosus. Stroke. 1989;20(5):583–91.

    PubMed  CAS  Google Scholar 

  8. Krishnan E. Stroke subtypes among young patients with systemic lupus erythematosus. Am J Med. 2005;118(12):1415.

    PubMed  Google Scholar 

  9. Ioannidis S, Mavridis M, Mitsias PD. Ischemic stroke as initial manifestation of systemic lupus erythematosus: a case report and review of the literature. eNeurologicalSci. 2018;13:26–30.

    PubMed  PubMed Central  Google Scholar 

  10. Hanly JG, Li Q, Su L, Urowitz MB, Gordon C, Bae SC, et al. Cerebrovascular events in systemic lupus erythematosus: results from an international inception cohort study. Arthritis Care Res. 2018;70(10):1478–87.

    Google Scholar 

  11. • Garcia D, Erkan D. Diagnosis and management of the antiphospholipid syndrome. N Engl J Med. 2018;378(21):2010–21. One of the landmark papers that summerized the diagnosis and management of antiphospholipid antibody syndrome.

    PubMed  CAS  Google Scholar 

  12. Unlu O, Zuily S, Erkan D. The clinical significance of antiphospholipid antibodies in systemic lupus erythematosus. Eur J Rheumatol. 2016;3(2):75–84.

    PubMed  Google Scholar 

  13. Arachchillage DR, Efthymiou M, Mackie IJ, Lawrie AS, Machin SJ, Cohen H. Anti-protein C antibodies are associated with resistance to endogenous protein C activation and a severe thrombotic phenotype in antiphospholipid syndrome. J Thromb Haemost. 2014;12(11):1801–9.

    PubMed  CAS  Google Scholar 

  14. Breen KA, Seed P, Parmar K, Moore GW, Stuart-Smith SE, Hunt BJ. Complement activation in patients with isolated antiphospholipid antibodies or primary antiphospholipid syndrome. Thromb Haemost. 2012;107(3):423–9.

    PubMed  CAS  Google Scholar 

  15. Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006;4(2):295–306.

    PubMed  CAS  Google Scholar 

  16. Pengo V, Ruffatti A, Legnani C, Testa S, Fierro T, Marongiu F, et al. Incidence of a first thromboembolic event in asymptomatic carriers of high-risk antiphospholipid antibody profile: a multicenter prospective study. Blood. 2011;118(17):4714–8.

    PubMed  CAS  Google Scholar 

  17. Kernan WN, Ovbiagele B, Black HR, Bravata DM, Chimowitz MI, Ezekowitz MD, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(7):2160–236.

    PubMed  Google Scholar 

  18. Samanta D, Cobb S, Arya K. Sneddon syndrome: a comprehensive overview. J Stroke Cerebrovasc Dis. 2019;28(8):2098–108.

    PubMed  Google Scholar 

  19. Cuadrado MJ, Bertolaccini ML, Seed PT, Tektonidou MG, Aguirre A, Mico L, et al. Low-dose aspirin vs low-dose aspirin plus low-intensity warfarin in thromboprophylaxis: a prospective, multicenter, randomized, open, controlled trial in patients positive for antiphospholipid antibodies (ALIWAPAS). Rheumatology (Oxford). 2014;53(2):275–84.

    CAS  Google Scholar 

  20. Ruiz-Irastorza G, Cuadrado MJ, Ruiz-Arruza I, Brey R, Crowther M, Derksen R, et al. Evidence-based recommendations for the prevention and long-term management of thrombosis in antiphospholipid antibody-positive patients: report of a task force at the 13th International Congress on antiphospholipid antibodies. Lupus. 2011;20(2):206–18.

    PubMed  CAS  Google Scholar 

  21. Levine SR, Brey RL, Tilley BC, Thompson JL, Sacco RL, Sciacca RR, et al. Antiphospholipid antibodies and subsequent thrombo-occlusive events in patients with ischemic stroke. JAMA. 2004;291(5):576–84.

    PubMed  CAS  Google Scholar 

  22. Crowther MA, Ginsberg JS, Julian J, Denburg J, Hirsh J, Douketis J, et al. A comparison of two intensities of warfarin for the prevention of recurrent thrombosis in patients with the antiphospholipid antibody syndrome. N Engl J Med. 2003;349(12):1133–8.

    PubMed  CAS  Google Scholar 

  23. Erkan D, Aguiar CL, Andrade D, Cohen H, Cuadrado MJ, Danowski A, et al. 14th International Congress on Antiphospholipid Antibodies: task force report on antiphospholipid syndrome treatment trends. Autoimmun Rev. 2014;13(6):685–96.

    PubMed  CAS  Google Scholar 

  24. Moyssakis I, Tektonidou MG, Vasilliou VA, Samarkos M, Votteas V, Moutsopoulos HM. Libman-Sacks endocarditis in systemic lupus erythematosus: prevalence, associations, and evolution. Am J Med. 2007;120(7):636–42.

    PubMed  Google Scholar 

  25. Roldan CA, Sibbitt WL Jr, Qualls CR, Jung RE, Greene ER, Gasparovic CM, et al. Libman-Sacks endocarditis and embolic cerebrovascular disease. JACC Cardiovasc Imaging. 2013;6(9):973–83.

    PubMed  PubMed Central  Google Scholar 

  26. Whitlock RP, Sun JC, Fremes SE, Rubens FD, Teoh KH. Antithrombotic and thrombolytic therapy for valvular disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e576S–600S.

    PubMed  PubMed Central  CAS  Google Scholar 

  27. Rodrigues M, Galego O, Costa C, Jesus D, Carvalho P, Santiago M, et al. Central nervous system vasculitis in systemic lupus erythematosus: a case series report in a tertiary referral centre. Lupus. 2017;26(13):1440–7.

    PubMed  CAS  Google Scholar 

  28. Devinsky O, Petito CK, Alonso DR. Clinical and neuropathological findings in systemic lupus erythematosus: the role of vasculitis, heart emboli, and thrombotic thrombocytopenic purpura. Ann Neurol. 1988;23(4):380–4.

    PubMed  CAS  Google Scholar 

  29. Unterman A, Nolte JE, Boaz M, Abady M, Shoenfeld Y, Zandman-Goddard G. Neuropsychiatric syndromes in systemic lupus erythematosus: a meta-analysis. Semin Arthritis Rheum. 2011;41(1):1–11.

    PubMed  Google Scholar 

  30. Urowitz MB, Gladman D, Ibanez D, Bae SC, Sanchez-Guerrero J, Gordon C, et al. Atherosclerotic vascular events in a multinational inception cohort of systemic lupus erythematosus. Arthritis Care Res. 2010;62(6):881–7.

    CAS  Google Scholar 

  31. Wang L, Chen H, Zhang Y, Liu W, Zheng W, Zhang X, et al. Clinical characteristics of cerebral venous sinus thrombosis in patients with systemic lupus erythematosus: a single-centre experience in China. J Immunol Res. 2015;2015:540738.

    PubMed  PubMed Central  Google Scholar 

  32. Saadatnia M, Sayed-Bonakdar Z, Mohammad-Sharifi G, Sarrami AH. Prevalence and prognosis of cerebrovascular accidents and its subtypes among patients with systemic lupus erythematosus in Isfahan, Iran: A Hospital Clinic-based Study. Int J Prev Med. 2014;5(1):123–6.

    PubMed  PubMed Central  Google Scholar 

  33. Cohen H, Hunt BJ, Efthymiou M, Arachchillage DR, Mackie IJ, Clawson S, et al. Rivaroxaban versus warfarin to treat patients with thrombotic antiphospholipid syndrome, with or without systemic lupus erythematosus (RAPS): a randomised, controlled, open-label, phase 2/3, non-inferiority trial. Lancet Haematol. 2016;3(9):e426–36.

    PubMed  PubMed Central  Google Scholar 

  34. Bousser MG, Ferro JM. Cerebral venous thrombosis: an update. Lancet Neurol. 2007;6(2):162–70.

    PubMed  CAS  Google Scholar 

  35. Cui HW, Lei RY, Zhang SG, Han LS, Zhang BA. Clinical features, outcomes and risk factors for posterior reversible encephalopathy syndrome in systemic lupus erythematosus: a case-control study. Lupus. 2019;28(8):961–9.

    PubMed  Google Scholar 

  36. Baizabal-Carvallo JF, Barragan-Campos HM, Padilla-Aranda HJ, Alonso-Juarez M, Estanol B, Cantu-Brito C, et al. Posterior reversible encephalopathy syndrome as a complication of acute lupus activity. Clin Neurol Neurosurg. 2009;111(4):359–63.

    PubMed  Google Scholar 

  37. Damrongpipatkul U, Oranratanachai K, Kasitanon N, Wuttiplakorn S, Louthrenoo W. Clinical features, outcome, and associated factors for posterior reversible encephalopathy in Thai patients with systemic lupus erythematosus: a case-control study. Clin Rheumatol. 2018;37(3):691–702.

    PubMed  Google Scholar 

  38. Jung SM, Moon SJ, Kwok SK, Ju JH, Park KS, Park SH, et al. Posterior reversible encephalopathy syndrome in Korean patients with systemic lupus erythematosus: risk factors and clinical outcome. Lupus. 2013;22(9):885–91.

    PubMed  CAS  Google Scholar 

  39. Hinchey J, Chaves C, Appignani B, Breen J, Pao L, Wang A, et al. A reversible posterior leukoencephalopathy syndrome. N Engl J Med. 1996;334(8):494–500.

    PubMed  CAS  Google Scholar 

  40. Mukherjee P, McKinstry RC. Reversible posterior leukoencephalopathy syndrome: evaluation with diffusion-tensor MR imaging. Radiology. 2001;219(3):756–65.

    PubMed  CAS  Google Scholar 

  41. Zhang L, Xu J. Posterior reversible encephalopathy syndrome (PRES) attributed to mycophenolate mofetil during the management of SLE: a case report and review. Am J Clin Exp Immunol. 2018;7(1):1–7.

    PubMed  PubMed Central  Google Scholar 

  42. Khajuria B, Khajuria M, Agrawal Y. Mycophenolate-induced posterior reversible encephalopathy syndrome. Am J Ther. 2016;23(4):e1072–3.

    PubMed  Google Scholar 

  43. Bertsias GK, Boumpas DT. Pathogenesis, diagnosis and management of neuropsychiatric SLE manifestations. Nat Rev Rheumatol. 2010;6(6):358–67.

    PubMed  Google Scholar 

  44. Piga M, Chessa E, Peltz MT, Floris A, Mathieu A, Cauli A. Demyelinating syndrome in SLE encompasses different subtypes: do we need new classification criteria? Pooled results from systematic literature review and monocentric cohort analysis. Autoimmun Rev. 2017;16(3):244–52.

    PubMed  Google Scholar 

  45. Greenberg BM. The neurologic manifestations of systemic lupus erythematosus. Neurologist. 2009;15(3):115–21.

    PubMed  Google Scholar 

  46. Miller DH, Weinshenker BG, Filippi M, Banwell BL, Cohen JA, Freedman MS, et al. Differential diagnosis of suspected multiple sclerosis: a consensus approach. Mult Scler. 2008;14(9):1157–74.

    PubMed  PubMed Central  CAS  Google Scholar 

  47. Theodoridou A, Settas L. Demyelination in rheumatic diseases. J Neurol Neurosurg Psychiatry. 2006;77(3):290–5.

    PubMed  PubMed Central  CAS  Google Scholar 

  48. Magro Checa C, Cohen D, Bollen EL, van Buchem MA, Huizinga TW, Steup-Beekman GM. Demyelinating disease in SLE: is it multiple sclerosis or lupus? Best Pract Res Clin Rheumatol. 2013;27(3):405–24.

    PubMed  Google Scholar 

  49. Asgari N, Jarius S, Laustrup H, Skejoe HP, Lillevang ST, Weinshenker BG, et al. Aquaporin-4-autoimmunity in patients with systemic lupus erythematosus: a predominantly population-based study. Mult Scler. 2018;24(3):331–9.

    PubMed  Google Scholar 

  50. Mader S, Jeganathan V, Arinuma Y, Fujieda Y, Dujmovic I, Drulovic J, et al. Understanding the antibody repertoire in neuropsychiatric systemic lupus erythematosus and neuromyelitis optica spectrum disorder: do they share common targets? Arthritis Rheum. 2018;70(2):277–86.

    CAS  Google Scholar 

  51. Parker BJ, Bruce IN. High dose methylprednisolone therapy for the treatment of severe systemic lupus erythematosus. Lupus. 2007;16(6):387–93.

    PubMed  CAS  Google Scholar 

  52. Saison J, Costedoat-Chalumeau N, Maucort-Boulch D, Iwaz J, Marignier R, Cacoub P, et al. Systemic lupus erythematosus-associated acute transverse myelitis: manifestations, treatments, outcomes, and prognostic factors in 20 patients. Lupus. 2015;24(1):74–81.

    PubMed  CAS  Google Scholar 

  53. Lavalle C, Pizarro S, Drenkard C, Sanchez-Guerrero J, Alarcon-Segovia D. Transverse myelitis: a manifestation of systemic lupus erythematosus strongly associated with antiphospholipid antibodies. J Rheumatol. 1990;17(1):34–7.

    PubMed  CAS  Google Scholar 

  54. Li XY, Xiao HB, Pai P. Myelitis in systemic lupus erythematosus. J Clin Neurosci. 2017;44:18–22.

    PubMed  Google Scholar 

  55. Bucci T, Menichelli D, Pignatelli P, Triggiani M, Violi F, Pastori D. Relationship of antiphospholipid antibodies to risk of dementia: a systematic review. J Alzheimers Dis. 2019;69(2):561–76.

    PubMed  CAS  Google Scholar 

  56. Barile-Fabris L, Ariza-Andraca R, Olguin-Ortega L, Jara LJ, Fraga-Mouret A, Miranda-Limon JM, et al. Controlled clinical trial of IV cyclophosphamide versus IV methylprednisolone in severe neurological manifestations in systemic lupus erythematosus. Ann Rheum Dis. 2005;64(4):620–5.

    PubMed  PubMed Central  CAS  Google Scholar 

  57. Mehmood T, Munir I, Abduraimova M, Ramirez MA, Paghdal S, McFarlane IM. Longitudinally extensive transverse myelitis associated with systemic lupus erythematosus: a case report and literature review. Am J Med Case Rep. 2019;7(10):244–9.

    PubMed  PubMed Central  Google Scholar 

  58. Giorgi D, Balacco GC. Optic neuropathy in systemic lupus erythematosus and antiphospholipid syndrome (APS): clinical features, pathogenesis, review of the literature and proposed ophthalmological criteria for APS diagnosis. Clin Rheumatol. 1999;18(2):124–31.

    PubMed  CAS  Google Scholar 

  59. Man BL, Mok CC, Fu YP. Neuro-ophthalmologic manifestations of systemic lupus erythematosus: a systematic review. Int J Rheum Dis. 2014;17(5):494–501.

    PubMed  Google Scholar 

  60. Henegar CE, Eudy AM, Kharat V, Hill DD, Bennett D, Haight B. Progressive multifocal leukoencephalopathy in patients with systemic lupus erythematosus: a systematic literature review. Lupus. 2016;25(6):617–26.

    PubMed  CAS  Google Scholar 

  61. Pavlovic AM, Bonaci-Nikolic B, Kozic D, Ostojic J, Abinun M, Svabic-Medjedovic T, et al. Progressive multifocal leukoencephalopathy associated with mycophenolate mofetil treatment in a woman with lupus and CD4+ T-lymphocyte deficiency. Lupus. 2012;21(1):100–2.

    PubMed  CAS  Google Scholar 

  62. Grebenciucova E, Berger JR. Progressive multifocal leukoencephalopathy. Neurol Clin. 2018;36(4):739–50.

    PubMed  Google Scholar 

  63. Panzer J, Dalmau J. Movement disorders in paraneoplastic and autoimmune disease. Curr Opin Neurol. 2011;24(4):346–53.

    PubMed  PubMed Central  Google Scholar 

  64. Sanna G, Bertolaccini ML, Cuadrado MJ, Laing H, Khamashta MA, Mathieu A, et al. Neuropsychiatric manifestations in systemic lupus erythematosus: prevalence and association with antiphospholipid antibodies. J Rheumatol. 2003;30(5):985–92.

    PubMed  Google Scholar 

  65. Poil AR, Yousef Khan F, Lutf A, Hammoudeh M. Chorea as the first and only manifestation of systemic lupus erythematosus. Case Rep Rheumatol. 2012;2012:907402.

    PubMed  PubMed Central  Google Scholar 

  66. Bertsias GK, Ioannidis JP, Aringer M, Bollen E, Bombardieri S, Bruce IN, et al. EULAR recommendations for the management of systemic lupus erythematosus with neuropsychiatric manifestations: report of a task force of the EULAR standing committee for clinical affairs. Ann Rheum Dis. 2010;69(12):2074–82.

    PubMed  CAS  Google Scholar 

  67. Reiner P, Galanaud D, Leroux G, Vidailhet M, Haroche J, du Huong LT, et al. Long-term outcome of 32 patients with chorea and systemic lupus erythematosus or antiphospholipid antibodies. Mov Disord. 2011;26(13):2422–7.

    PubMed  Google Scholar 

  68. Kampylafka EI, Alexopoulos H, Kosmidis ML, Panagiotakos DB, Vlachoyiannopoulos PG, Dalakas MC, et al. Incidence and prevalence of major central nervous system involvement in systemic lupus erythematosus: a 3-year prospective study of 370 patients. PLoS One. 2013;8(2):e55843.

    PubMed  PubMed Central  CAS  Google Scholar 

  69. Kampylafka EI, Alexopoulos H, Fouka P, Moutsopoulos HM, Dalakas MC, Tzioufas AG. Epileptic syndrome in systemic lupus erythematosus and neuronal autoantibody associations. Lupus. 2016;25(11):1260–5.

    PubMed  CAS  Google Scholar 

  70. Huang X, Magder LS, Petri M. Predictors of incident seizure in systemic lupus erythematosus. J Rheumatol. 2016;43(3):565–75.

    PubMed  CAS  Google Scholar 

  71. Devinsky O, Schein A, Najjar S. Epilepsy associated with systemic autoimmune disorders. Epilepsy Curr. 2013;13(2):62–8.

    PubMed  PubMed Central  Google Scholar 

  72. Valencia I. Epilepsy in systemic autoimmune disorders. Semin Pediatr Neurol. 2014;21(3):226–31.

    PubMed  Google Scholar 

  73. Ho RC, Thiaghu C, Ong H, Lu Y, Ho CS, Tam WW, et al. A meta-analysis of serum and cerebrospinal fluid autoantibodies in neuropsychiatric systemic lupus erythematosus. Autoimmun Rev. 2016;15(2):124–38.

    PubMed  CAS  Google Scholar 

  74. Kim JM, Kwok SK, Ju JH, Kim HY, Park SH. Idiopathic intracranial hypertension as a significant cause of intractable headache in patients with systemic lupus erythematosus: a 15-year experience. Lupus. 2012;21(5):542–7.

    PubMed  Google Scholar 

  75. Hershko AY, Berkun Y, Mevorach D, Rubinow A, Naparstek Y. Increased intracranial pressure related to systemic lupus erythematosus: a 26-year experience. Semin Arthritis Rheum. 2008;38(2):110–5.

    PubMed  Google Scholar 

  76. Mikdashi J, Kennedy S, Krumholz A. Recurrent benign lymphocytic (mollaret) meningitis in systemic lupus erythematosus. Neurologist. 2008;14(1):43–5.

    PubMed  Google Scholar 

  77. Hanly JG, Urowitz MB, O'Keeffe AG, Gordon C, Bae SC, Sanchez-Guerrero J, et al. Headache in systemic lupus erythematosus: results from a prospective, international inception cohort study. Arthritis Rheum. 2013;65(11):2887–97.

    PubMed  Google Scholar 

  78. Badry R, Gamal RM. Different types of headache in patients with systemic lupus erythematosus. Int J Neurosci. 2015;125(5):357–60.

    PubMed  CAS  Google Scholar 

  79. Katsiari CG, Vikelis M, Paraskevopoulou ES, Sfikakis PP, Mitsikostas DD. Headache in systemic lupus erythematosus vs multiple sclerosis: a prospective comparative study. Headache. 2011;51(9):1398–407.

    PubMed  Google Scholar 

  80. • Zhao Z, Rocha NP, Salem H, Diniz BS, Teixeira AL. The association between systemic lupus erythematosus and dementia. A meta-analysis. Dement Neuropsychol. 2018;12(2):143–51. This meta-analysis showed a significant association of both systemic lupus erythematosus and antiphospholipid syndrome with cognitive impairement.

    PubMed  PubMed Central  Google Scholar 

  81. Gendelman O, Tiosano S, Shoenfeld Y, Comaneshter D, Amital H, Cohen AD, et al. High proportions of dementia among SLE patients: a big data analysis. Int J Geriatr Psychiatry. 2018;33(3):531–6.

    PubMed  Google Scholar 

  82. Lin YR, Chou LC, Chen HC, Liou TH, Huang SW, Lin HW. Increased risk of dementia in patients with systemic lupus erythematosus: a nationwide population-based cohort study. Arthritis Care Res. 2016;68(12):1774–9.

    Google Scholar 

  83. Petri M, Naqibuddin M, Sampedro M, Omdal R, Carson KA. Memantine in systemic lupus erythematosus: a randomized, double-blind placebo-controlled trial. Semin Arthritis Rheum. 2011;41(2):194–202.

    PubMed  PubMed Central  CAS  Google Scholar 

  84. • Bortoluzzi A, Piga M, Silvagni E, Chessa E, Mathieu A, Govoni M. Peripheral nervous system involvement in systemic lupus erythematosus: a retrospective study on prevalence, associated factors and outcome. Lupus. 2019;28(4):465–74. Important large retrospective analysis that investigated the prevalence of peripheral nervous system involvement in systemic lupus erythematosus.

    PubMed  CAS  Google Scholar 

  85. Florica B, Aghdassi E, Su J, Gladman DD, Urowitz MB, Fortin PR. Peripheral neuropathy in patients with systemic lupus erythematosus. Semin Arthritis Rheum. 2011;41(2):203–11.

    PubMed  Google Scholar 

  86. Xianbin W, Mingyu W, Dong X, Huiying L, Yan X, Fengchun Z, et al. Peripheral neuropathies due to systemic lupus erythematosus in China. Medicine (Baltimore). 2015;94(11):e625.

    Google Scholar 

  87. Riviere E, Cohen Aubart F, Maisonobe T, Maurier F, Richez C, Gombert B, et al. Clinicopathological features of multiple mononeuropathy associated with systemic lupus erythematosus: a multicenter study. J Neurol. 2017;264(6):1218–26.

    PubMed  Google Scholar 

  88. Vina ER, Fang AJ, Wallace DJ, Weisman MH. Chronic inflammatory demyelinating polyneuropathy in patients with systemic lupus erythematosus: prognosis and outcome. Semin Arthritis Rheum. 2005;35(3):175–84.

    PubMed  CAS  Google Scholar 

  89. Jallouli M, Saadoun D, Eymard B, Leroux G, Haroche J, Le Thi HD, et al. The association of systemic lupus erythematosus and myasthenia gravis: a series of 17 cases, with a special focus on hydroxychloroquine use and a review of the literature. J Neurol. 2012;259(7):1290–7.

    PubMed  CAS  Google Scholar 

  90. Shalimar HR, Deepak KK, Bhatia M, Aggarwal P, Pandey RM. Autonomic dysfunction in systemic lupus erythematosus. Rheumatol Int. 2006;26(9):837–40.

    PubMed  CAS  Google Scholar 

  91. Allenbach Y, Benveniste O. Acquired necrotizing myopathies. Curr Opin Neurol. 2013;26(5):554–60.

    PubMed  CAS  Google Scholar 

  92. Ellis E, Ann Tan J, Lester S, Tucker G, Blumbergs P, Roberts-Thomson P, et al. Necrotizing myopathy: clinicoserologic associations. Muscle Nerve. 2012;45(2):189–94.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, Carver College of Medicine, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA

    Amir Shaban & Enrique C. Leira

  2. Department of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City, IA, USA

    Enrique C. Leira

  3. Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA

    Enrique C. Leira

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Shaban, A., Leira, E.C. Neurological Complications in Patients with Systemic Lupus Erythematosus. Curr Neurol Neurosci Rep 19, 97 (2019). https://doi.org/10.1007/s11910-019-1012-1

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