Lifting the fog of neuropsychiatric lupus

Abstract

This thesis describes studies of individuals with systemic lupus erythematosus (SLE) presenting with neuropsychiatric (NP) symptoms at the Leiden NPSLE clinic. A diverse range of studies, including laboratory, radiological, clinical and patient´s reported outcomes are presented.

The Leiden NPSLE clinic is a tertiary referral center for patients with SLE and neuropsychiatric (NP) symptoms. In the NPSLE clinic, patients are assessed by a multidisciplinary team. Thereafter, clinical, radiological and laboratory measures are weighed in a consensus meeting to correctly attribute the NP symptoms: related to lupus activity (NPSLE) or not. This extensive and standardized assessment of NPSLE, a rare and heterogenous disease lacking a gold standard, is unique and creates the opportunity to explore many aspects of NPSLE in well-defined phenotypes.

In the first part of this thesis, we evaluate both classification and treatment of patients with

SLE and NP symptoms. The second part of this thesis focuses on a diverse range of clinical outcomes of NPSLE, including both morbidity and mortality. The last part of this thesis assesses potential biomarkers for (specific manifestations of) NPSLE.