Clinical, imaging characteristics, and outcomes of neuropsychiatric lupus patient admitted to a referral neurology hospital in Bangladesh: A prospective study

Objective This study aimed to describe the clinical and neuroimaging characteristics and 120-day outcomes in neuropsychiatric systemic lupus erythematosus patients. Methods This prospective study involved 32 patients with systemic lupus erythematosus who presented with neuropsychiatric symptoms. The Systemic Lupus Erythematosus Disease Activity Index 2000 was used to evaluate disease activity. Standard treatments were administered, and patients were followed up for 120 days. Outcomes were assessed in terms of remission, partial remission, and mortality. Results The most prevalent neuroimaging characteristics were microhemorrhage in eight patients (25%), hemorrhagic infarct in four patients (12%), and ischemic infarct in four patients (12%). Additionally, magnetic resonance angiography of the cerebral artery revealed a beaded appearance in the middle cerebral artery or its branches in nine patients (28%). Magnetic resonance venography showed a filling defect, narrowing, and irregularity of the superior sagittal and transverse sinus in five patients (16%). Upon admission, the mean Systemic Lupus Erythematosus Disease Activity Index 2000 score was 24 (SD = 9). After receiving standard treatment, complete remission occurred in 24 patients (75%) and partial remission in 7 patients (22%), with a median Systemic Lupus Erythematosus Disease Activity Index 2000 score of 2 (interquartile range = 1–4.5) at 120 days, p = 0.02. Conclusion Magnetic resonance angiography of cerebral vessels helps confirm vasculitis. Patients generally experience satisfactory outcome with standard treatment at 4 months.