Manifestations neuropsychiatriques au cours du lupus érythémateux systémique: à propos de 108 cas au Cameroun

Few data on neuropsychiatric disorders in systemic lupus erythematosus (NPSLE) are available in sub-Saharan Africa. The purpose of this study was to determine their frequency and describe their features in Cameroon. We conducted a retrospective study collecting all the medical records of patients with systemic lupus erythematosus (SLE) hospitalized in the department of rheumatology of 3 hospitals in Cameroon from 2009 to 2019. Lupus activity was assessed using the SLE activity index (SLEDAI). A total of 108 records of patients with a mean age of 40.2 ± 13.7 years were included in the study. The frequency of NPSLE was 55.5% (n=60). Neuropsychiatric disorders were diagnosed concomitantly with SLE (37.0%; n = 40) while in 20 patients with SLE (18.5%) they occurred during the first year. When NPSLE were inaugural, central nervous system involvement was dominant, with demyelinating syndrome 27.8% (n=30) and headaches 21.3% (n=23). Mononeuropathy was the most frequent peripheral nervous system involvement (15.7%; n=17). Factors associated with NPSLE occurrence were malar rash (p=0.024), alopecia (p=0.024), very high lupus activity (p=0.011), arthralgia (p<0.001), anti-nuclear factor (p=0.002). NPSLE did not appear to influence either lupus activity (log rank p=0.227) or the probability of new onset lupus (log rank p=0.233). More than half of patients had NPSLE during the first year. The presence of cutaneous and articular signs, high lupus activity, and anti-nuclear factor were associated with the occurrence of NPSLE.