Relationship Between Cognitive Dysfunction (MoCA-INA Score) with Disease Activity, Erythrocyte Sedimentation Rate, and C-Reactive Protein in Systemic Lupus Erythematosus Patients

Relationship Between Cognitive Dysfunction (MoCA-INA Score) with Disease Activity, Erythrocyte Sedimentation Rate, and C-Reactive Protein in Systemic Lupus Erythematosus Patients

Authors

  • Bantar Suntoko Doctoral Study Program of Medical and Health Science, Faculty of Medicine ,University of Diponegoro, Semarang Indonesia, Indonesia
  • Suyanto Hadi Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine , University of Diponegoro / Kariadi Hospital, Semarang Indonesia, Indonesia
  • Elfian Rachmawati Department of Internal Medicine, Faculty of medicine, University of Diponegoro / Kariadi Hospital, Semarang Indonesia, Indonesia
  • Suharyo Hadisaputro Division of Tropical infectious Diseases, Department of Internal Medicine, Faculty of Medicine University of Diponegoro/ Kariadi Hospital, Semarang Indonesia, Indonesia
  • Handono Kalim Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine University of Brawijaya/ Saiful Anwar Hospital, Malang Indonesia, Indonesia

DOI:

https://doi.org/10.36408/mhjcm.v9i3.799

Keywords:

cognitive dysfunction, c-reactive protein, disease activity, erythrocyte sedimentation rate, systemic lupus erythematosus.

Abstract

BACKGROUND: Neuropsychiatric Systemic Lupus Erythematosus (NPSLE) is one of the clinical manifestations affecting the brain in SLE, which the most frequent condition was cognitive dysfunction (CD). CD has a negative impact on the quality of life of SLE patients and causes impaired social function and reduced work productivity. Previous studies regarding correlation between cognitive dysfunction with disease activity, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) showed various results.

AIM: The purpose of this study was to assess the correlation of CD using MoCA- INA score with disease activity (SLEDAI-2K score), ESR and CRP in SLE patients.

METHODS: A cross-sectional study design was applied in this research. The subjects of this research were SLE patients measured by MoCA-INA score, SLEDAI-2K score, ESR, and CRP. Spearman rank correlation test was applied in this study to assess the relationship of the variables.

RESULT: The study subjects consisted of 53 women diagnosed with SLE with an average age of 34 years old. 49.1 % of the subjects had high school education background. There was a moderate significant correlation between MoCA-INA score and ESR (r= -0.408, p=0.002) and also to CRP (r= -0.314 p=0.022). There was no significant correlation of disease activity and MoCA-INA score (r = -0.086 p = 0.539).

CONCLUSION: The low levels of ESR and CRP were associated with CD in SLE patients.

KEYWORDS: cognitive dysfunction, c-reactive protein, disease activity, erythrocyte sedimentation rate, systemic lupus erythematosus.

Downloads

Download data is not yet available.

References

Fan Y, Hao YJ, Zhang ZL. Systemic lupus erythematosus: year in review 2019. Chin Med J (Engl) 2020;133(18):2189-96.

Alzughayyar TZ, Zalloum JS, Elqadi MN, Abukhalaf SA, Abunejma FM, Alkhanafsa MMY, et al. Systemic Lupus Erythematosus with Multiple Autoimmune Disease Presented with Extensive Peripheral Gangrene. Case Rep Rheumatol. 2020;1-5.

Sumariyono, Kalim H, Setyohadi B, Hidayat R, Najirman, Hamijoyo L, et al. Rekomendasi Perhimpunan Reumatologi Indonesia Diagnosis Dan Pengelolaan Lupus Eritematosus Sistemik. Perhimpunan Reumatologi Indonesia; 2019.

Justiz Vaillant AA, Goyal A, Varacallo M. Systemic Lupus Erythematosus. 2022 Jul 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.

Magro-Checa C, Beaart-Van De Voorde LJJ, Middelkoop HAM, et al. Outcomes of neuropsychiatric events in systemic lupus erythematosus based on clinical phenotypes; Prospective data from the Leiden NP SLE cohort. Lupus. 2017;26(5):543-551.

Adamichou C, Bertsias G. Flares in systemic lupus erythematosus: diagnosis, risk factors and preventive strategies. Mediterr J Rheumatol 2017;28(1):4-12.

Narayanan CK MC, Shanmuganandan CK, Shankar Gp. Correlation between systemic lupus erythematosus disease activity index, c3, c4 and anti-dsdna antibodies. Med J Armed Forces India 2010; 66:102–7.

Koelmeyer R, Tri Nim H, Nikpour M, B Sun Y, Kao A, Guenther O, et al. High disease activity status suggests more severe disease and damage accrual in systemic lupus erythematosus. Lupus Science and medicine 2020.

Saepudin A, Ong PA, Hidayat S, Rahmadi AR, Hamijoyo L, et al. Correlation between cognitive function with Disease Activity of systemic lupus erythematosus patients in Dr. Hasan Sadikin Hospital Bandung: An analytical cross-sectional study. Indonesian journal of rheumatology. 2019;11(1):130-136.

Nantes SG, Su J, Dhaliwal A, Colosimo K. Performance of screening tests for cognitive impairment in LES. J Rheumatol. 2017;44(11):1583-89

Ho RC, Husain SF, Ho CS. Cognitive dysfunction in patients with systemic lupus erythematosus: The challenge in diagnosis and management. Rheumatol Pract Res. 2018; 3:1-12

Paez-Venegas N, Jordan-Estrada B, Chavarria-Avila E, Perez-Vazquez F, Gomez-Bañuelos E, et al. The Montreal cognitive assessment test: a useful tool in screening of cognitive impairment in patients with LES. J Clin Rheumatol. 2019;25(8):325-28

Barraclough M, McKie S, Parker B, Jackson A, Pemberton P, Elliott R, et al. Altered cognitive function in systemic lupus erythematosus and associations with inflammation and functional and structural brain changes. Ann Rheum Dis. 2019 Jul;78(7):934-940.

Tomietto P, Annese V, D’Agostini S, et al. General and specific factors associated with severity of cognitive impairment in systemic lupus erythematosus. Arthritis Care Res. 2007;57(8):1461-1472.

Olazarán J, López-Longo J, Cruz I, Bittini A, Carreño L. Cognitive dysfunction in systemic lupus erythematosus: Prevalence and correlates. Eur Neurol. 2009;62(1):49-55.

Ajalia S, Ong PA, Atik N, Hamijoyo L, et al. Memory Performance in Patient with Systemic Lupus Erythematosus Using MoCA-Ina in Hasan Sadikin Genneral Hospital Bandung. Indonesian Journal of Rheumatology. 2017;9(1) :25-28.

Gordon C, Amissah-Arthur MB, Gayed M, Brown S, Bruce IN, D'Cruz D, et al. The British Society for Rheumatology guideline for the management of systemic lupus erythematosus in adults. Rheumatology (Oxford). 2018;57(1): e1-e45.

Hanly JG, Urowitz MB, Su L, Bae SC, Gordon C, Wallace DJ, et al. Prospective analysis of neuropsychiatric events in an international disease inception cohort of patients with systemic lupus erythematosus. Ann Rheum Dis. 2010;69(3):529-35.

El-Shafey AM, Abd-El-Geleel SM, Soliman ES. Cognitive impairment in nonneuropsychiatric systemic lupus erythematosus. Egypt Rheum. 2012;34(2):67–73.

Allan C, Magbitang AT, Hernandez AT, Kenneth, Salido, Evelyn, et al. Assessment of cognitive impairment in systemic lupus erythematosus patients in a rheumatology outpatient clinic of a tertiary government hospital using the mini-mental status exam and the montreal cognitive assessment test-filipino versions. 2014; 2014:1-3.

Maneeton B, Maneeton N, Louthrenoo W. Cognitive deficit in patients with systemic lupus erythematosus. Asian Pac J Allergy Immunol 2010;28(1):77–83.

Chalhoub NE, Luggen ME. Screening for Cognitive Dysfunction in Systemic Lupus Erythematosus: The Montreal Cognitive Assessment Questionnaire and the Informant Questionnaire on Cognitive Decline in the Elderly. SAGE Journal. 2019:51-8.

Keenan RT, Swearingen CJ, Yazici Y. Erythrocyte sedimentation rate and C-reactive protein levels are poorly correlated with clinical measures of disease activity in rheumatoid arthritis, systemic lupus erythematosus and osteoarthritis patients. Clin Exp Rheumatol. 2008;26(5):814–9.

Shucard JL, Gaines JJ, Ambrus J Jr, Shucard DW. C-reactive protein and cognitive deficits in systemic lupus erythematosus. Cogn Behav Neurol. 2007 Mar;20(1):31-7.

Watanabe Y, Kitamura K, Nakamura K, Sanpei K, Wakasugi M, Yokoseki A, et al. Elevated C-Reactive Protein Is Associated with Cognitive Decline in Outpatients of a General Hospital: The Project in Sado for Total Health (PROST). Dement Geriatr Cogn Dis Extra. 2016 Jan 19;6(1):10-9.

Additional Files

Published

2022-11-30

How to Cite

1.
Sutoko B, Hadi S, Rachmawati E, Hadisaputro S, Kalim H. Relationship Between Cognitive Dysfunction (MoCA-INA Score) with Disease Activity, Erythrocyte Sedimentation Rate, and C-Reactive Protein in Systemic Lupus Erythematosus Patients : Relationship Between Cognitive Dysfunction (MoCA-INA Score) with Disease Activity, Erythrocyte Sedimentation Rate, and C-Reactive Protein in Systemic Lupus Erythematosus Patients . Medica Hospitalia J. Clin. Med. [Internet]. 2022 Nov. 30 [cited 2024 Dec. 22];9(3):306-12. Available from: http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/799

Issue

Section

Original Article

Citation Check