Headache in systemic lupus erythematosus and its relation to other diseasemanifestations

Objective To investigate headache in systemic lupus erythematosus (SLE) and its relation to other disease manifestations. Methods Clinical and laborat ory 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 pat ients who reported moderate to severe headache on at least two consecutive encounters, and Group B consisted of the remainder of the patients, with mi ld 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 f atigue. They also had higher disease activity scores, and a higher number s howed central nervous involvement There were no significant differences bet ween the two groups in any of the laboratory variables examined, nor in the proportion of patients with renal involvement. The prevalence of non-throm boembolic central nervous system (CNS) manifestations was 7.2%. The sensiti vity of headache for the diagnosis of nonthromboembolic 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 e ach found to be significantly independently related to headache. Conclusions Headache is common in SLE, and in the majority of patients is r elated to musculoskeletal and constitutional disease manifestations.