Acute Manic Episode and Psychosis as Early Manifestations of Systemic Lupus Erythematosus with Lupus Nephritis: A Case Report

This case report discusses a 37-year-old woman who initially presented with manic and psychotic symptoms, which were later identified as early manifestations of systemic lupus erythematosus (SLE) with lupus nephritis. The patient exhibited psychiatric symptoms before the more typical physical signs of SLE, such as hair loss and skin pigmentation changes. Her condition worsened with fever and gastrointestinal symptoms, leading to a diagnosis of an acute SLE flare precipitated by sepsis. After proactive management, including hemodialysis, the patient recovered significantly. The report highlights the importance of comprehensive examinations to differentiate between psychiatric symptoms as early signs of SLE or as an aggravation of an underlying mental disorder.