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The association between the antiphospholipid antibody syndrome and neuropsychological impairment in SLE

Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa

J J Spangenberg

Department of Psychology, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa

R Rickman

Department of Medical Microbiology, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa

F H Hugo

M Roberts

Department of Psychiatry, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa

Objective: To examine the relationship between neuropsychological impairment and antiphospholipid antibody syndrome (aPL syndrome) in patients with systemic lupus erythermatosus (SLE).

Patients: Sixty-nine patients satisfying ACR criteria were studied. Sixteen patients with the aPL syndrome and 53 patients without the syndrome were subjected to eight neuropsychological tests, a physical examination and serological investigations. No patients with other pathology, known to cause acute or chronic impairment of neuropsychological function, were included. Sixty-five underwent MRI scans.

Results: There were no significant differences in age, level of education, incidence of hypertension or disease activity in the two groups. Pearson's correlation coefficients revealed a significant negative correlation with duration of disease in six out of eight tests in the aPL positive group and one out of eight in the aPL negative group. This suggests that aPL syndrome may be involved in the psychological impairment in SLE patients. A larger cohort needs to be studied to confirm this observation.

Key Words: antiphospholipid antibody syndrome • SLE • neuropsychological impairment

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