Biomarkers in Pediatric Neuropsychiatric Systemic Lupus Erythematosus: A Systematic Review

This is the protocol for a systematic review aiming To evaluate and synthesize current evidence on the diagnostic, predictive, or disease-monitoring value of biomarkers in pediatric patients with neuropsychiatric systemic lupus erythematosus (pNPSLE). Inclusion criteria Population: Children and adolescents (≤18 years old) diagnosed with SLE and presenting neuropsychiatric symptoms. Study Types: Original peer-reviewed studies (cohort, case-control, cross-sectional). Intervention/Exposure: Measurement of biomarkers related to neuropsychiatric involvement in SLE. Outcomes: Diagnostic accuracy, association with NP symptoms, or prognostic relevance of biomarkers. Exclusion criteria Case reports, case series, review articles. Studies without separate pediatric data. Animal studies or non-human participants. Studies without data on relevant biomarkers. Databases and Search Strategy Databases searched: We followed the PRISMA guidelines to perform a systematic literature search of articles relevant to pediatric NPSLE and biomarkers in four databases PubMed (n=24) EMBASE (n=24) Scopus (n=7) Google Scholar (n=48) A total of 29 studies were selected for data extraction and narrative synthesis.Data were extracted manually from full texts and supplementary materials. Extracted information included: author, year, country, study design, population size, NP symptomatology, biomarker type and measurement method, sensitivity/specificity, and association with NP outcomes.The Newcastle-Ottawa Scale (NOS) adapted for cohort, case-control, and cross-sectional studies was used. Quality grading followed the AHRQ thresholds. Most studies were of poor quality due to small samples and lack of control for confounding.A qualitative synthesis was performed. No meta-analysis was conducted due to high heterogeneity in study designs, biomarkers, and outcome measures.