59-05-032 Proceeding

202 Proceedings of the Princess Maha Chakri Sirindhorn Congress PREVALENCE AND OUTCOME OF SEIZURE RELATED TO SYSTEMIC LUPUS ERYTHEMATOSUS Yu-Hsuan Hu Intern, Chang Gung Memorial Hospital Kuang-Hui Yu Division of Allergy, Immunology and Rheumatology, Chang Gung Memorial Hospital Abstract : Objective: To investigate the risk factors associated with systemic lupus erythematosus (SLE) related seizure and the long-term outcome of SLE related seizure. Methods: The medical records of 691 SLE hospitalized patients followed up in Chang Gung Medical Center in Taiwan from 2005 to 2014 were retrospectively reviewed. Results: 691 patients (11.3%men) who fulfilled at least four of the ACR criteria for SLE were studied. The mean onset age of SLE was 36.3 ± 16.4 years. 72 patients (10.4%) had SLE-related seizure. Univariate analysis indicated that independent predictors of seizure were photosensitivity, serositis, proteinuria, leukopenia, lymphopenia, thrombocytopenia, psychosis, hypertension, diabetic mellitus, and end stage renal disease. Multivariate Cox regression analysis indicated that independent predictors of mortality were onset age above 50 years at admission (HR 2.62, 95% CI 1.54 4 - .45, p < 0.001), male (HR 2.36, 95% CI 1.24 - 4.49, p = 0.009), serositis (HR 2.86, 95%CI 1.72 - 4.76, p < 0.001), leukopenia (HR 2.06, 95% CI 1.14 - 3.70, p=0.016), thrombocytopenia (HR3.84, 95%CI 2.08 - 7.09, p<0.001), seizure (HR1.94, 95% CI 1.12-3.35, p = 0.018), and anti-dsDNA positivity (HR 0.43, 95% CI 0.25 - 0.74, p = 0.002). Conclusions : This study underlines the prevalence and outcome of seizure in SLE, which is significant related to patient survival rates. Survival was significantly lower in patients with seizure than that in patients without. The results of this study provide the information that closely follows up of SLE patients with seizure may be necessary. Keywords : systemic lupus erythematosus, seizure, outcome I. Introduction Systemic lupus erythematosus (SLE) is a chronic multisystem inflammatory autoimmune disease. Clinical features in individual patients can be quite variable, ranging frommild joint and skin involvement to severe life-threatening internal organ disease. Nervous system involvement is a well-recognizedmanifestation of SLE, which is one of the 11 AmericanCollege of Rheumatology (ACR) criteria for the classification of SLE [1]. The prevalence and outcome of seizure in SLE varies widely depending on the patient selection, whether routing screening investigations or not. Seizure is not uncommon in patients with SLE. Seizures occur in 7% to 40% of SLE patients, with an average of ~15% [2~5]. Seizures are also associated with increasedmorbidity andmortality in adults and children [3~4]. However, only limited papers regarding the prevalence, global risk, prognostic factors and survival of seizure involvement in SLE have been reported from Taiwan. In this study, we reviewed the records of