Neuropsychiatric Systemic Lupus Erythematosus Presenting as Bipolar I Disorder With Catatonic Features

The document reported on a 15-year-old African American girl who was initially diagnosed with Bipolar I disorder with catatonic features after presenting symptoms of an affective disorder. Despite multiple hospitalizations and psychiatric treatments, her symptoms persisted. Two years later, she developed a malar rash and cerebral vasculitis, which led to a diagnosis of Neuropsychiatric Systemic Lupus Erythematosus (NPSLE). Following treatment with steroids, her mental health improved significantly, eliminating the need for psychiatric medication or therapy. This case underlines the necessity of considering NPSLE in young patients with neuropsychiatric symptoms, as these may be early signs of SLE rather than a primary psychiatric disorder. The document also points out the high occurrence of NPSLE in pediatric SLE patients and the diagnostic difficulties due to the diverse neuropsychiatric manifestations of the disease.