Lifting the fog of neuropsychiatric lupus

Monahan, R.C. (2023)

Doctoral Thesis

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.

• Lupus
• Neuropsychiatric
• Brain
• Autoimmunity
• Antibody
• SF-36
• Fatigue
• Mortality
• Cognition

• All authors: Monahan, R.C.
• Supervisor: Huizinga, T.W.J.; Kloppenburg, M.
• Co-supervisor: Steup-Beekman, G.M.
• Committee: Fronczek, R.; Middelkoop, H.A.M.; Mosca, M.; Rosendaal, F.R.; Voskuyl, A.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2023-03-30
• ISBN (print): 9789464197402
• Sponsorship: Nationale Vereniging voor Lupus; APS; Sclerodermie en MCTD (NVLE); Chipsoft; UCB Pharma