Organ damage accrual in patients with newly onset systemic lupus erythematosus with neuropsychiatric symptoms and its clinical features in daily clinical practice: a single-center study

This study was conducted to reveal specific clinical features, outcomes and risk factors of organ damage in patients with systemic lupus erythematosus (SLE) with neuropsychiatric (NP) symptoms upon initial onset. Patients with newly diagnosed SLE at our institute between 2010 and 2022 were enrolled. Patients who exhibited NP symptoms at initial onset constituted the initial onset NPSLE (Ini-NPSLE) group, and their clinical features were compared with those of patients without NP symptoms (SLE NP- group). Among 90 patients with newly onset SLE (mean age 37.7 years), there were 20 patients in the Ini-NPSLE group and 70 patients in the SLE NP- group. General clinical characteristics were similar between the two groups, except for diagnostic delay, arthritis and avascular necrosis. The Ini-NPSLE group showed significantly higher SLE Disease Activity Index scores at admission (24.8 vs. 15.6) and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) scores (1.55 vs. 0.53) at the end of follow-up. Logistic regression analysis revealed that patients' age and NPSLE were associated with organ damage (SDI ≥ 1) in patients with newly onset SLE. This study suggests that clinicians must focus on early NP symptoms to manage later organ damage in patients with SLE.