Abstract

Objective: Neuropsychiatric (NP) involvement in juvenile onset systemic lupus erythematosus (jSLE) is associated with increased morbidity and diagnostic challenges. Data regarding pediatric populations remain limited. This study aimed to determine the prevalence, clinical features, imaging findings, and treatment outcomes of neuropsychiatric SLE (NPSLE) at a tertiary pediatric rheumatology center.

Materials and Methods: This retrospective study included 46 jSLE patients followed between 2015 and 2025. Patients were classified as NPSLE or non-NPSLE. Demographic, clinical, laboratory, imaging, and treatment data were analyzed.

Results: NPSLE was identified in 14 (30.4%) patients, and it was predominantly observed at disease onset. Patients with NPSLE had significantly higher disease activity at the time of diagnosis (p=0.001). Seizures (n=5, 10.8%) and depression (n=2, 4.3%) were the most common symptoms. Anti-ribosomal P antibody positivity was more common in NPSLE patients (p=0.019). Macrophage activation syndrome was observed in 3 (6.5%) patients, all of whom were in the NPSLE group. All patients received corticosteroids and hydroxychloroquine, and most were treated with cyclophosphamide. At the final follow-up, disease activity had significantly decreased, and most patients achieved low disease activity without neurological sequelae.

Conclusion: NPSLE is a common and severe manifestation of jSLE and is associated with high disease activity. Early and aggressive immunosuppressive therapy may play a critical role in controlling disease activity and improving prognosis.

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Copyright © 2026 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Erdem Torun Ş, Polat MC, Özçelik E, Ekici Tekin Z, Çelikel E, Karagöl C, et al. Clinical characteristics and outcomes of neuropsychiatric involvement in juvenile systemic lupus erythematosus. Turk J Pediatr Dis. 2026;Early View:1-8. https://doi.org/10.12956/TJPD.2026.1379