Cargando…

Psychotic symptoms in a patient with Systemic Lupus Erythematosus: A diagnostic dilemma between lupus psychosis and steroid induced psychosis

INTRODUCTION: Systemic Lupus Erythematosus (SLE) is a chronic auto-immune disorder with the involvement of multiple organ systems. It is more common in females. CASE PRESENTATION: Here, we present a case of 12-year-old female, known case of SLE with lupus nephritis, presenting with neuropsychiatric...

Descripción completa

Detalles Bibliográficos
Autores principales: Pathak, Bishnu Deep, Regmi, Binit Upadhaya, Dhakal, Bishal, Joshi, Sushil, Simkhada, Nabin, Sapkota, Suhail, Joshi, Sushant, Thapa, Sujan Rana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9793111/
https://www.ncbi.nlm.nih.gov/pubmed/36582883
http://dx.doi.org/10.1016/j.amsu.2022.104843
_version_ 1784859786023534592
author Pathak, Bishnu Deep
Regmi, Binit Upadhaya
Dhakal, Bishal
Joshi, Sushil
Simkhada, Nabin
Sapkota, Suhail
Joshi, Sushant
Thapa, Sujan Rana
author_facet Pathak, Bishnu Deep
Regmi, Binit Upadhaya
Dhakal, Bishal
Joshi, Sushil
Simkhada, Nabin
Sapkota, Suhail
Joshi, Sushant
Thapa, Sujan Rana
author_sort Pathak, Bishnu Deep
collection PubMed
description INTRODUCTION: Systemic Lupus Erythematosus (SLE) is a chronic auto-immune disorder with the involvement of multiple organ systems. It is more common in females. CASE PRESENTATION: Here, we present a case of 12-year-old female, known case of SLE with lupus nephritis, presenting with neuropsychiatric symptoms. She was under steroids as well for a few weeks due to flare-up of symptoms prior to that. Due to this, there was a diagnostic dilemma between lupus psychosis and steroid induced psychosis. CLINICAL DISCUSSION: Approximately one third to half of the patients may have neurological involvement in Systemic Lupus Erythematosus. However, neuropsychiatric symptoms in them could be due to corticosteroids, which are frequently used in treatment. There are no definitive and easily available laboratory markers to distinguish these two aetiologies. CONCLUSIONS: Systemic Lupus Erythematosus patients, who are on steroids, with neuropsychiatric features should be assessed adequately. As there are no specific guideline and biomarkers to distinguish between these two, meticulous evaluation is necessary for appropriate management.
format Online
Article
Text
id pubmed-9793111
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-97931112022-12-28 Psychotic symptoms in a patient with Systemic Lupus Erythematosus: A diagnostic dilemma between lupus psychosis and steroid induced psychosis Pathak, Bishnu Deep Regmi, Binit Upadhaya Dhakal, Bishal Joshi, Sushil Simkhada, Nabin Sapkota, Suhail Joshi, Sushant Thapa, Sujan Rana Ann Med Surg (Lond) Case Report INTRODUCTION: Systemic Lupus Erythematosus (SLE) is a chronic auto-immune disorder with the involvement of multiple organ systems. It is more common in females. CASE PRESENTATION: Here, we present a case of 12-year-old female, known case of SLE with lupus nephritis, presenting with neuropsychiatric symptoms. She was under steroids as well for a few weeks due to flare-up of symptoms prior to that. Due to this, there was a diagnostic dilemma between lupus psychosis and steroid induced psychosis. CLINICAL DISCUSSION: Approximately one third to half of the patients may have neurological involvement in Systemic Lupus Erythematosus. However, neuropsychiatric symptoms in them could be due to corticosteroids, which are frequently used in treatment. There are no definitive and easily available laboratory markers to distinguish these two aetiologies. CONCLUSIONS: Systemic Lupus Erythematosus patients, who are on steroids, with neuropsychiatric features should be assessed adequately. As there are no specific guideline and biomarkers to distinguish between these two, meticulous evaluation is necessary for appropriate management. Elsevier 2022-11-07 /pmc/articles/PMC9793111/ /pubmed/36582883 http://dx.doi.org/10.1016/j.amsu.2022.104843 Text en © 2022 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Pathak, Bishnu Deep
Regmi, Binit Upadhaya
Dhakal, Bishal
Joshi, Sushil
Simkhada, Nabin
Sapkota, Suhail
Joshi, Sushant
Thapa, Sujan Rana
Psychotic symptoms in a patient with Systemic Lupus Erythematosus: A diagnostic dilemma between lupus psychosis and steroid induced psychosis
title Psychotic symptoms in a patient with Systemic Lupus Erythematosus: A diagnostic dilemma between lupus psychosis and steroid induced psychosis
title_full Psychotic symptoms in a patient with Systemic Lupus Erythematosus: A diagnostic dilemma between lupus psychosis and steroid induced psychosis
title_fullStr Psychotic symptoms in a patient with Systemic Lupus Erythematosus: A diagnostic dilemma between lupus psychosis and steroid induced psychosis
title_full_unstemmed Psychotic symptoms in a patient with Systemic Lupus Erythematosus: A diagnostic dilemma between lupus psychosis and steroid induced psychosis
title_short Psychotic symptoms in a patient with Systemic Lupus Erythematosus: A diagnostic dilemma between lupus psychosis and steroid induced psychosis
title_sort psychotic symptoms in a patient with systemic lupus erythematosus: a diagnostic dilemma between lupus psychosis and steroid induced psychosis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9793111/
https://www.ncbi.nlm.nih.gov/pubmed/36582883
http://dx.doi.org/10.1016/j.amsu.2022.104843
work_keys_str_mv AT pathakbishnudeep psychoticsymptomsinapatientwithsystemiclupuserythematosusadiagnosticdilemmabetweenlupuspsychosisandsteroidinducedpsychosis
AT regmibinitupadhaya psychoticsymptomsinapatientwithsystemiclupuserythematosusadiagnosticdilemmabetweenlupuspsychosisandsteroidinducedpsychosis
AT dhakalbishal psychoticsymptomsinapatientwithsystemiclupuserythematosusadiagnosticdilemmabetweenlupuspsychosisandsteroidinducedpsychosis
AT joshisushil psychoticsymptomsinapatientwithsystemiclupuserythematosusadiagnosticdilemmabetweenlupuspsychosisandsteroidinducedpsychosis
AT simkhadanabin psychoticsymptomsinapatientwithsystemiclupuserythematosusadiagnosticdilemmabetweenlupuspsychosisandsteroidinducedpsychosis
AT sapkotasuhail psychoticsymptomsinapatientwithsystemiclupuserythematosusadiagnosticdilemmabetweenlupuspsychosisandsteroidinducedpsychosis
AT joshisushant psychoticsymptomsinapatientwithsystemiclupuserythematosusadiagnosticdilemmabetweenlupuspsychosisandsteroidinducedpsychosis
AT thapasujanrana psychoticsymptomsinapatientwithsystemiclupuserythematosusadiagnosticdilemmabetweenlupuspsychosisandsteroidinducedpsychosis