Neurologische of psychiatrische symptomen bij patiënten met lupus erythematodes disseminatus (SLE): terminologische problemen, pathogenese, diagnostiek en therapie

- The nomenclature of the American College of Rheumatology leads to misunderstandings in multidisciplinary discussions on patients with systemic lupus erythematosus (SLE) who also have neurological or psychiatric symptoms.

- These proposed neuropsychiatric syndromes are rarely syndromes and the symptoms are rarely neuropsychiatric.

- It is better first of all to determine whether the SLE patients have neurological or psychiatric symptoms, and if these symptoms are present, the first question is what is the cause.

- Vasculitis of the cerebral blood vessels should be considered as a possible explanation only if ischaemic lesions in the brain have been demonstrated, other causes of cerebral ischaemia in SLE are unlikely, and the clinical signs are consistent with cerebral vasculitis.

- These other causes of cerebral ischaemia include: antiphospholipid antibodies, atherosclerosis, heart valve disorders and thrombotic thrombocytopenic purpura.

Ned Tijdschr Geneeskd. 2006;150:367-72