MRI in neuropsychiatric systemic lupus erythematosus (NPSLE)

Systemic lupus erythematosus (SLE) is a multifaceted autoimmune disease affecting especially many organs including the nervous system. In systemic lupus erythematosus, neuropsychiatric manifestations occur in up to 4 out of 5 cases [Futrell N et al. Neurology 1992; 42: 1649. DOI: 10.1212/wnl.42.9.1649]. In such a neuropsychiatric systemic lupus erythematosus (NPSLE), both psychiatric and neurological symptoms of the central, peripheral and autonomic nervous system are present. The prevalence of NPSLE clearly depends on the corresponding symptoms and varies widely between 14 and 95 %, but is highest for cognitive impairment [Govoni M et al. Journal of Autoimmunity 2016; 74: 41. DOI: 10.1016/j.jaut.2016.06.013]. As the CNS manifestations of SLE are often very difficult to grasp clinically/anamnestically, the prevalence figures fluctuate accordingly. Imaging is therefore a very important component in the diagnosis, especially as the CNS manifestation is decisive for treatment.