B – 57 Assessment of Cognitive Impairment due to Multiple Etiologies in a Case of Childhood Onset Systemic Lupus Erythematosus

Abstract Objective Systemic lupus erythematosus (SLE) is a chronic autoimmune disease capable of both directly and indirectly affecting both the central nervous system and other anatomical divisions. SLE’s etiology is unknown and generally understood as multifactorial in nature, and the disease can present with a wide range of symptoms and comorbid conditions of varying severity. Although the list of documented neuropsychiatric symptoms and cognitive dysfunctions associated with SLE continues to grow, established correlates include headache, seizure, stroke, and cognitive impairments such as memory loss. Method The current case is a 26-year-old, right-handed, African American female with childhood-onset SLE with multi-organ involvement. SLE manifestations and complications have included neuropsychiatric SLE (NPSLE), lupus nephritis (LN), rheumatoid pericarditis (RA), vasculitis, posterior reversible encephalopathy syndrome (PRES), and antiphospholipid syndrome (APS), among others. Past neuropsychological testing was conducted to determine whether this patient was experiencing cognitive deficits associated with NPSLE (2019) and past leukemia treatment (2022). Her 2019 neuropsychological testing revealed subtle neurocognitive deficits, and her 2022 testing revealed mild to moderate neurocognitive deficits with some evidence of decline. Results This patient’s performance on the present neurocognitive battery suggests continued mild to moderate deficits in attention, immediate and working memory, cognitive processing speed, motor speed, and visuospatial perception and memory. This patient continues to report subjective worsening of her neurocognitive symptoms, especially in the areas of memory and attention as well as anxiety and depression. Conclusion This case explores neuropsychiatric symptoms and cognitive dysfunctions associated with SLE and comorbid conditions. Neuropsychological testing can help monitor these phenomena across the lifespan.