Autoantibodies and neuropsychiatric manifestations in childhood-onset systemic lupus erythematosus

Methods We included consecutive cSLE followed at the pediatric rheumatology unit of the State University of Campinas. Neurological manifestations were analyzed according to the ACR classification criteria. Cognitive evaluation was performed in all participants using Wechsler Intelligence Scale for children (WISC-III) and Wechsler Intelligence Scale for adults (WAIS), according to age and validated in Portuguese. Mood disorders were determined through Becks Depression and Anxiety Inventory in all participants. SLE patients were further assessed for clinical and laboratory SLE manifestations, disease activity [SLE Disease Activity Index (SLEDAI)], damage [Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)] and current drug exposures. Antiribosomal P protein antibodies, S100b and NF-H were tested by ELISA using commercial kits. The levels of dsDNA antibodies were determined by indirect immunofluorescence using Crithidiaas a substrate and were considered positive if they were higher than 110. The levels of precipitating antibodies to extractable nuclear antigens (ENA), including Sm, were detected using a standardized enzyme-linked immunosorbent assay (ELISA) method and were considered positive if higher than 180. The levels of IgG and IgM anticardiolipin antibodies (aCL) were measured by ELISA. Lupus anticoagulant (LA) activity was detected by coagulation assays in platelet-free plasma obtained by double centrifugation following the recommendations of the Scientific and Standardization Committee of the International Society of Thrombosis and Homeostasis subcommittee on LA Antiphospholipid (aCL and LA), anti-dsDNA and antiSmith were obtained of the medical charts. Data were compared by non-parametric tests.