Neuropsychiatric Lupus: Two Sides of the Same Coin

The document discusses two pediatric cases of neuropsychiatric lupus, a complex manifestation of systemic lupus erythematosus, highlighting the diagnostic challenges due to atypical presentations. Patient A, a 16-year-old female, presented with acute psychiatric symptoms and neurological signs, while Patient B, a 13-year-old female, exhibited movement disorder symptoms. Both cases required a multidisciplinary approach for diagnosis and management, involving various specialists and comprehensive assessments. Despite the absence of typical lupus features, both patients responded positively to a treatment regimen including steroids, hydroxychloroquine, cyclophosphamide, and rituximab. The study emphasizes the importance of a vigilant, collaborative approach in managing neuropsychiatric lupus, particularly in pediatric cases, to improve outcomes and quality of life.