ab17_4

Headache in systemic lupus erythematosus and its relation to other disease manifestations

M. Amit¹,³, Y. Molad²,³, O. Levy¹,³, A.J. Wysenbeek¹,³

¹Department of Medicine B and Rheumatology Service, Assaf Harofeh Medical Center, Zerifin; ²Department of Medicine D and Rheumatology Unit, Rabin Medical Center, Beilinson Campus, Petah Tiqva; ³Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel.

ABSTRACT
Objective
To investigate headache in systemic lupus erythematosus (SLE) and its relation to other disease manifestations.

Methods
Clinical and laboratory variables of 148 SLE patients were prospectively recorded in a computed data base.

Results
The patients were divided into two groups. Group A consisted of patients who reported moderate to severe headache on at least two consecutive encounters, and Group B consisted of the remainder of the patients, with mild or no headache. The two groups did not significantly differ in age or in sex distribution.
Patients in Group A suffered from more severe joint pain and inflammation, muscle pain, photosensitivity, mouth ulcers, fever and fatigue. They also had higher disease activity scores, and a higher number showed central nervous involvement. There were no significant differences between the two groups in any of the laboratory variables examined, nor in the proportion of patients with renal involvement. The prevalence of non-thromboembolic central nervous system (CNS) manifestations was 7.2%. The sensitivity of headache for the diagnosis of non-thromboembolic CNS manifestations was 90.9%, and the specificity was 29.2%. On logistic regression analysis, the total arthritis score, muscle pain, fatigue and photosensitivity were each found to be significantly independently related to headache.

Conclusions
Headache is common in SLE, and in the majority of patients is related to musculoskeletal and constitutional disease manifestations.

Key words
Systemic lupus erythematosus, headache.

This manuscript was presented as an abstract in the 1997 annual meeting of the American College of Rheumatology (Amit M, Molad Y, Wysenbeek AJ. Headache in systemic lupus erythematosus and its relation to other disease manifestations. Arthritis Rheum 1997; 40: S256).

Please address correspondence and reprint requests to: Dr. M. Amit, Department of Internal Medicine B, "Assaf Harofeh" Medical Center, Zerifin 70300, Israel.
E-mail: vazinam@post.tau.ac.il