Predictors of neuropsychiatric manifestations in pediatric patients with lupus

Early detection of neuropsychiatric systemic lupus erythematosus (NPSLE) in children remains a challenge. Previous studies have found an association between different autoantibodies and the occurrence of NPSLE. This study aimed to describe the autoantibodies, organ disorders, SLEDAI-2K score, and complement levels at diagnosis in systemic lupus erythematosus (SLE) and to investigate the predictors of NPSLE. We reviewed medical records and extracted information on the clinical features, serum autoantibodies, and laboratory test results of hospitalized children with SLE (< 18 years old). Multivariable logistic regression was used to determine the predictors of NPSLE and SLE without neuropsychiatric manifestations. The 22.8% children with NPSLE had higher ANA levels and SLEDAI-2K scores, lower C4 levels, and greater AMA-M2, β2GPI Abs, Anti-Rib-P Ab, ANCA, and LAC positivity at SLE diagnosis. They were also more likely to have fever and more easily developed digestive system complications, macrophage activation syndrome (MAS), and hypothyroidism. The predictors of NPSLE were β2GPI-Abs (OR = 4.603), anti-Rib-P Ab (OR = 4.153), and SLEDAI-2K score (OR = 1.215). The study indicates that the SLEDAI-2K score, β2GPI-Abs, and anti-Rib-P Ab were predictors of NPSLE. Our findings may have implications for NPSLE screening in patients with SLE.